Adherence to diabetes care: Knowledge of biochemical processes has a high impact on glycaemic control among adolescents with type 1 diabetes

Efrat Dagan, Ilana Dubovi, Milana Levy, Nehama Zuckerman Levin, Sharona T. Levy

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Aim: To 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. Design: A cross-sectional study. Methods: Adolescents 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 Paediatric 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. Results: Ninety-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 and 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. Conclusions: Causal-biochemical knowledge is a valuable component for the adherence to diabetes care and glycaemic control. Impact: Our study suggests that causal knowledge is a valuable component that should be included in nursing and healthcare educational programmes for adolescents with type 1 diabetes mellitus.

Original languageEnglish
Pages (from-to)2701-2709
Number of pages9
JournalJournal of Advanced Nursing
Volume75
Issue number11
DOIs
StatePublished - 1 Nov 2019

Keywords

  • HbA1c
  • adherence to treatment
  • adolescents
  • causal-biochemical knowledge
  • nursing
  • patient education
  • self-management knowledge
  • type 1 diabetes mellitus

ASJC Scopus subject areas

  • General Nursing

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