ESPE Abstracts

Introduction: Mental health comorbidities are getting more recognized in children with chronic illness like Type 1 Diabetes Mellitus (T1DM). Increased rates of depressive symptoms and anxiety dis¬orders in pediatric patients with TIDM have been found in many previous studies. However, not much literature is available regarding impact of multidisciplinary intervention in pediatric patients with T1DM in developing countries where there is increased patient load with lack of time for counselling. Hence, we have planned this study to see the impact of an interventional tool on emotional and behavioral profile of children with T1DM.

Material and methods: A prospective interventional study was conducted in the department of Pediatrics, Pt. B.D.S. PGIMS, Rohtak from April 2021 to March 2022. Children in the age group of 6-14 years with Type 1 DM diagnosed within last 1 year were enrolled from Pediatric outpatient department, endocrinology clinic and wards. Sick Children with Diabetic Keto acidosis/ Hyperosmolar Coma, neurological illness, IQ less than 80 and on anti-epileptic drugs were excluded. After undergoing a baseline assessment, they were subjected to emotional and behavioral assessment as per Strength and difficulties questionnaire (SDQ) and Self-perception profile for children. They were later subjected to an interventional tool which included one to one counselling of the mother and child, showing them a brief video film regarding insulin administration, providing them booklet regarding knowledge about T1DM, sessions with dietician, psycho- behavioral session with child psychologist to address their psychological issues once in a month for 3 months and incorporating telemedicine in their management. Same scores were applied to these children after 6 months and the data was analyzed using appropriate statistical methods.

Results: Forty-eight patients were enrolled during the study period. Average mean age was 9.2 years and M:F ratio was 1:1.7. HbA1c significantly declined from a mean of 11.8(1.6SD) to 8.9(1.1SD) (P<0.05). Initially, patients had higher scores in SDQ specially in emotional problem scale, hyperactivity and peer problem scale and lower scores for prosocial behavior. Post intervention there was significant decline in Total difficulties score in SDQ; specially in Emotional symptoms and Hyperactivity subscale (P< 0.001). Self-perception profile scoring also showed significant improvement in scholastic competence and global self-worth scores after the intervention (P<0.05).

Conclusion: This study has highlighted role of multidisciplinary intervention programme in the management of T1DM. Improvement in emotional and behavioral profile should also be considered as a goal in the management of TIDM.