Adherence behaviours in Taiwanese children and adolescents with type 1 diabetes mellitus

Aims and objective. To describe the current non-adherence behaviours of Taiwanese children with type 1 diabetes mellitus. Background. Poor adherence to prescribed protocols of long-term therapies is a pervasive and costly problem in the care of children with chronic illnesses. Non-adherence to diabetes mellitus treatment regimens of Taiwanese children with type 1 diabetes mellitus in Taiwan has not been well documented. Design. Cross-sectional data were collected from 101 patients who had type 1 diabetes mellitus and were between the ages of 10 and 18 years. Method. Five types of adherence behaviours were measured: number of calories consumed per day, frequency of meals, self-monitoring of blood glucose, amount of time between injections and meals and frequency of exercise. Results. Only 25% of patients consumed the ideal daily number of calories (within +/- 10% of the ideal range), while 48% of patients consumed 10% fewer calories than the suggested ideal daily number of calories. Only 28% of patients consumed the ideal percentage (50-60%) of calories from carbohydrates. Approximately 15% of patients consumed > 60% of their calories from carbohydrates and 30% of their calories from fat. Approximately 30% of patients ate their meals 20-40 minutes after injection; some patients ate their meals within 20 minutes after injection (45% in the morning and 33% in the evening). For frequency of meals, most patients (>= 90%) ate their regular three meals, three or four times per day; only 18% ate the ideal number of six times per day. For self-monitoring of blood glucose, most patients (> 70%) tested their blood sugar twice a day, once in the morning and again in the evening. In terms of frequency of exercise, 48% of patients exercised once per day and 43% of patients did not exercise at all. Only 7% of patients met the good diabetes control of HbA(1c) < 7%; almost half of the patients had HbA(1c) > 10%. Conclusions. Overall, the patients had poor adherence behaviours in each aspect of diabetes mellitus management and diabetes control total glycosylated haemoglobin (HbA(1c)) was very poor. Relevance to clinical practice. Studies are needed to explore factors related to non-adherence to treatment regimens as well as poor control of diabetes among Taiwanese children with type 1 DM.