ESPE Abstracts

Topic: Compliance for monitoring of glycemic control in children with type 1 diabetes.

Background and Aims: To estimate attachment of children with type 1 diabetes to self-control of blood glucose with help of automatically data processing system of glycemic control.

Method: We have checked 54 patients with first type diabetes at the age 14±3, 4 years old (32 males, 22 females), divided into two age groups: from 0 to 14, and 15-18 years old. There were 54 glycemic checking with help of automatic system of the analyzing self-monitoring results quantity of self-control of blood glucose per 24 h estimated based on last. The compliance self-monitoring index was calculated (quantity of the tests done/quantity of the recommended tests (5)*100%). Compliance index more than 90% has considered acceptable.

Results: Median quantity of average checking are 4.3 (3.2; 5.3) a day, median compliance index is 85% (64;106), average value of HbA1c 8.1%±1.8, shows insufficient compliance in total group. Median quantity of average checking in girls’ cases are much higher (Me 4.8 vs 3.6, P=0.04), either the compliance self-monitoring index too (Me 96.3 vs 72.9%, P=0.03). In two age groups – from 0 to 14, and 15–18 years old, median quantity of average checking (Me 4.4 (3.6; 6) vs 3.7 (2.6; 4.7)), P=0.08, and the compliance self-monitoring index (Me 87.2% (73; 116) vs 74% (51; 93.2)), P=0.09 did not differ significantly. But in group 0–14 years old average HbA1c value 7, 6%±1.1 is much lower, than in 15–18 years old group -average HbA1c value 8.6%±2.1. Patients with HbA1c <7.5% (21/54, 39%), (average HbA1c value 6.7%±0.5) have better glycemic control. Median quantity of average checking is 4.7 (3.6; 6.1), median compliance index is 93% (73;122), than patients with HbA1c ≥7.5% (33/54, 61%), (average HbA1c value 9%±1.8) – median quantity of average checking is 3.9 (2.6; 4.6), P=0.05, median compliance index is 78% (52;92), P=0.04.

Conclusion: Automatic system of the analyzing and estimation of the glycemic control gives opportunity to estimate the compliance of self-monitoring tests in first type diabetes in children and shows satisfactory to self-monitoring skills. However, girls’ cases were better than in boys’ cases. Optimal management of type 1 diabetes in elder group presumably depends not only on frequent blood glucose monitoring, but other factors, such as puberty, stress, eating disorder, adult supervision too.