Journal of advanced nursing | 2019
Adherence to diabetes care: knowledge of biochemical processes has a high impact on glycemic control among adolescents with type-1 diabetes.
Abstract
AIM\nTo evaluate the impact of patients understanding of biochemical processes involved in glucose regulation (causal-biochemical knowledge) and of diabetes self-management knowledge on adherence to treatment recommendations among adolescents with type 1 diabetes mellitus.\n\n\nDESIGN\nA cross-sectional study.\n\n\nMETHODS\nAdolescents with type 1 diabetes mellitus, aged 12-18 years and able to read and write in Hebrew or in Arabic were eligible. Participants were recruited between August 2016 - January 2018 during routine visits to the Pediatric Diabetes Clinic; informed consent was obtained as customary. Patients completed sociodemographic, clinical and type 1 diabetes mellitus self-management and biochemical knowledge questionnaires. Adherence to treatment was assessed by patients serum HbA1c levels, collected from medical records.\n\n\nRESULTS\nNinety-seven patients participated in the study. Mean HbA1c levels were 9.2% (1.9%) and only 24 (24.7%) patients met the recommended HbA1c ≤7.5%. Lower HbA1c levels were strongly associated with higher family income, older age at diagnosis, as well as with better type 1 diabetes mellitus self-management and causal-biochemical knowledge. A regression model showed that causal-biochemical knowledge contributed to the variance in HbA1c levels. Furthermore, causal-biochemical knowledge, but not self-management knowledge, was found to mediate the negative relationship between low family income and high HbA1c levels.\n\n\nCONCLUSIONS\nCausal-biochemical knowledge is a valuable component for the adherence to diabetes care and glycemic control.\n\n\nIMPACT\nOur study suggests that causal knowledge is a valuable component that should be included in nursing and health care educational programs for adolescents with type 1 diabetes mellitus. This article is protected by copyright. All rights reserved.