ESPE Abstracts

Background: CHRYSTAL (Costs and Health Related qualitY of life Study for Type 1 diAbetes mellitus pediatric patients in Spain) is an observational study conducted in 2014 on a representative sample of 275 patients aged 1-17 years with Type 1 Diabetes Mellitus (T1DM) in Spain.

Objective and hypotheses: One of the objectives of the study was to describe the adherence to diabetes care using the Self Care Inventory (SCI), and to compare results by HbA1c level for pediatric patients with T1DM in Spain.

Method: Patients were asked to respond to the SCI, in a single visit, which is a 15-item self-report scale (each ranged from 1 to 5, 5 being the highest possible adherence level) to assess patients’ perceptions of their adherence to diabetes self-care recommendations including the following dimensions: blood glucose testing and monitoring, insulin and food regulation, exercise, and emergency precautions. The overall and groups dimensions mean scores for CSI were calculated. Results by HbA1c level (HbA1c <7.5% vs HbA1c ≧ 7.5%) were analyzed by Mann-Whitney U test.

Results: Overall adherence scores were 4.03 (HbA1c <7.5%, n=161) vs 3.87 (HbA1c ≧ 7.5%, n=114), (P=.047). ‘Blood glucose regulation’, ‘Insulin and food regulation’, and ‘Emergency precautions’ are significantly different by HbA1c level (4.58 vs 4.43, P=.035; 4.08 vs 3.88, P=.027; and 4.72 vs 4.63, P=.028, respectively). ‘Exercise’ had the lowest adherence score but does not statistically differ by HbA1c level (3.11 vs 3.17, P=.588).

Conclusion: Perception of adherence to diabetes care is an important factor to consider while managing diabetes. Overall adherence and some dimensions significantly differ by HbA1c levels. Consistently with the literature, the study concludes that children and adolescents’ with higher levels of self-care were associated with better HbA1c levels than those with lower levels of self-care.

Funding information: This work was supported by Eli Lilly and Company.