Environmental factors affecting management of type 1 diabetes in children below the age of 10

Introduction. The way parents manage diabetes of their small children and environmental influence are crucial for maintaining glycemic control. The aim of the study was to assess environmental factors affecting metabolic control of young children with T1D treated with insulin pumps. Material and methods. Parents of children with T1D under the age of 10 years completed: General Self-Efficacy Scale, Parental Diabetes Quality of Life Questionnaire, Beck Depression Inventory and a questionnaire on socioeconomic factors. Results. There were analyzed 165 questionnaires. 66% of children achieved HbA1c <7.5% (<58mmol/mol). Factors associated with HbA1c≥7.5% (≥58mmol/mol) in the multiple logistic regression: single-parent families (p=0.003), low income <250EURO (p=0.017), parental education (p<0.05), snacking without parents’ permission (p=0.0006) and in parents of children ≥6 year of age – quality of life (p=0.037). In families of children <6 year of age, parents had higher self-efficacy than parents of children ≥6 year of age (p=0.046). Conclusions. Parents of young children are not homogeneous group and face different challenges. Young children of parents withlower education level and living in single-parent families are at high risk of poor diabetes management. More attention should be paid to the problem of young children snacking without parents’ permission.  Abbreviations: BDI – Beck Depression Inventory, CI–Confidence Intervals, GSES – General Self-Efficacy Scale, HbA1c – glycated hemoglobin, OR- Odds Ratio, PDQOLQ – Parental Diabetes Quality of Life Questionnaire, T1D – type 1 diabetes