Adherence to insulin pump treatment declines with increasing age in adolescents with type 1 diabetes mellitus.

Abstract

This study assessed the impact of illness perceptions, emotional responses to the disease and its management, and patient characteristics on the adherence to optimal insulin pump management in adolescents with type 1 diabetes mellitus. From May to December 2013 and May 2015 to September 2016, we investigated 90 adolescents (50% boys), 12-18years with type 1 diabetes. We analysed the association of optimal adherence to insulin pump therapy to age, gender, diabetes duration, results of questionnaires relating to fear and problems of self-testing, illness perceptions, emotional distress and family conflicts. Optimal adherence was defined as bolusing insulin on average ≥2.5/3 main meals/d. Adolescents with suboptimal adherence were on average 1.8years older (95% Confidence Interval 1.09-2.50years, P<.001) than those with optimal adherence. After adjustment for age, no other patient or parent factors were related to optimal adherence. Adherence to insulin pump self-management in adolescents with type 1 diabetes declined with increasing age, illustrating the challenges of transition of self-management from parents to the adolescent patient themselves.