Impact of tailored diabetes education on adherence and glycemic control in children and adolescents on continuous subcutaneous insulin infusion, prospective interventional study in a tertiary center.

BACKGROUND

Structured diabetes education plays a crucial role in the management of Type 1 Diabetes (T1D), especially with advanced technologies such as continuous subcutaneous insulin infusion (CSII). This study evaluates the impact of tailored education on adherence and glycemic control among pediatric CSII users.

PATIENTS AND METHODS

This interventional analytical study included 30 patients diagnosed with T1D with age ranged from 5 to 18 years, recruited from Diabetes & Endocrinology Clinic at tertiary university-based children's hospital. Patients were recruited for one year duration. Patients who were on multiple daily injection (MDI) for 2 to 10 years were shifted to CSII after receiving comprehensive diabetes education. Their education level was assessed individually using a questionnaire to assess patients' knowledge and application skills at the time of insulin pump insertion, 3 and 6 months later. Twenty-five patients were on mini-med 715, 10 patients used flash glucose monitoring, and 15 patients used self-monitoring blood sugar, while five patients were on mini-med 780G and continuous glucose monitoring (CGM) using guardian 4 (G4).

RESULTS

Study included 19 females (63.3%) and 11 males (36.7%) with age ranged from 7 to 11 with mean ± SD of 10.74 ± 1.86. Patients' education level was assessed before pump insertion, and 3 months later which shows significant improvement in patients' diabetes knowledge and technical skills with P-value 0.038. Also, time in range (TIR) improved significantly in well-educated patients at 3 and 6 months with P-values 0.048 and 0.025 respectively. There was highly significant improvement of HbA1c after 6 months (8.82 ± 1.5 vs. 7.18 ± 0.56) with P-value 0.000 after receiving diabetes education.

CONCLUSIONS

Tailored diabetes education significantly improves adherence and glycemic outcomes in pediatric patients using CSII. Integrating structured educational programs with diabetes technology is essential to achieve optimal metabolic control in youth.