ESPE Abstracts

Background & objectives: An important aspect of managing type 1 diabetes is to identify and address the apprehensions of patients and parents of newly diagnosed type 1 diabetes. Understanding parental difficulties in managing type1 diabetes and promptly dealing them will surely affect the short and long-term outcome in children. The aim of this study was to determine the affective response of parents after the diagnosis of type 1 diabetes in a developing country like Pakistan.

Methods: Questionnaire analysis of economic and psychosocial aspects of all newly diagnosed type 1 diabetes parents presenting in a tertiary care unit.

Results: A total of 79 parents were enrolled in the study. The monthly family income of 66/79 (83%) children was less than Rs.50,000 while 10/79 (13%) had more than Rs.50,000 and only 3/79 (4%) had income more than Rs.100,000. The economic standards were used in view of the economic background and their income level which added to their psychosocial stresses in the management of children on one hand and economic support on the other for sustainable health of the child. 62/79 (78%) parents felt depressed, 11/79 (14%) felt sense of guilt and 6/79 (8%) were in denial after diagnosis.73/79 (93%) were not accepting injectable insulin as first line treatment and wanted to try some other form of treatment like oral medications and homeopathy mainly because of financial constraints. 66/79 (83%) of parents main concern was regular injections and continuous glucose monitoring. This was again due to affordability of glucose strips and insulin injections. Therefore these 83% families asked for complete financial support for treatment of their child while 4% needed only partial support. All parents showed concerns about their child life expectancy and long-term medical complications. 64/79 (81%) were worried about coping of studies and schooling with type1 diabetes, 6/79 (8%) about their marriage and 2/79 (3%) about future career and jobs. 55/79 (69%) parents were inquiring about inheritance and worried about chances of sibling to be affected.

Conclusion: Parents of type 1 diabetes are prone to psychosocial affects with depression being the most common followed by sense of guilt and denial. Main stressing aspect was daily insulin injections, regular 4-6 times monitoring with pen-pricks fear, affording of glucose monitoring strips and their impact on child’s daily life, schooling, physical activities and psychological well-being.