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Current Diabetes Reviews


ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

Research Article

Factors Influencing Adherence Among Youth with Type-1-Diabetes Mellitus - The Hungarian Case

Author(s): Beáta E. Nagy , Brigitta Munkácsi and Karolina Eszter Kovács*

Volume 17, Issue 2, 2021

Published on: 20 January, 2020

Page: [222 - 232] Pages: 11

DOI: 10.2174/1573399816666200120123719


Background and Introduction: Due to the increasing prevalence of type-1-diabetes, an increasing number of studies have drawn attention to its psychological effects and long-term consequences. As Type 1 Diabetes Mellitus is a chronic, non-curable, yet maintainable condition, with the affected children and their families facing a lifelong challenge, our research focuses on the factors influencing adherence.

Methods: The adherence of youth was examined in a sample involving 114 patients treated in the Medical and Health Science Centre at the University of Debrecen by employing a new adherence questionnaire (DAQ abbreviated version, Munkácsi et al. 2019) (DAF 2017; N=114). The influence of socio- demographic variables and those related to the disease (age at the time of diagnosis, the time elapsed since diagnosis, method of treatment, the time elapsed since the use of the pump) was measured by linear regression. Furthermore, the between-group comparisons were made by independent sample t-tests and variance analysis. The investigation was carried out between September 2017 and May 2018.

Results: The effect of using insulin pump as therapy turned out to be significant and positive (0.36. p=0.045). It was observed that the adherence of the patients using insulin pump was higher while the effect of the age at the diagnosis had a significantly negative effect (-.247, p=0.035). Thus, earlier detection of the disease may lead to a higher level of adherence. The effects of the socio-demographic variables (gender, family structure, educational level, type of the settlement, owning sibling and birth order) were not significant (p>0.05). Regarding the between-group comparisons, a significant difference could be pointed out concerning the siblings and birth-order as the adherence of those with siblings was higher (p=0.044). Moreover, concerning insulin pump therapy, the adherence of patients using pump was significantly better (p=0.048). Also, regarding the age of the diagnosis, the adherence of those diagnosed before 12 was seemingly higher (p=0.039). Concerning the other socio-demographical and disease-related variables, no significant differences could be detected.

Conclusion: The results suggest that the treatment has an outstanding role in the adherence of the disease. Moreover, the role of the appropriate treatment, living conditions as well as the early diagnosis is relevant.

Keywords: Type-1-diabetes, adherence, mental health, insulin pump, socio-economic background, early diagnosis, therapy.

Guariguata L, Nolan T, Beagley J, Linnenkamp U, Jacqmain O, Eds. IDF Diabetes Atlas. 6th ed.
Körner A. SOS Cukor! Párbeszéd a diabéteszről [SOS Sugar! Dialogue on diabetes] Oriold és Társai Kiadó: Budapest In: 2013.
Jawaid A, Sohaila A, Mohammad N, Rabbani U. Frequency, clinical characteristics, biochemical findings and outcomes of DKA at the onset of type-1 DM in young children and adolescents living in a developing country - an experience from a pediatric emergency department. J Pediatr Endocrinol Metab 2019; 32(2): 115-9.
[] [PMID: 30699071]
Ilyés I, Felszeghy E, Juhász É. Az inzulinrezisztencia gyermek- és serdülőkorban I. Gyermekgyogyaszat 2014; 65(4): 265-8.
Ilyés I, Felszeghy E, Juhász É. Az inzulinrezisztencia gyermek- és serdülőkorban II. Gyermekgyogyaszat 2014; 65(5): 339-42.
Plotnick LP, Clark LM, Brancati FL, Erlinger T. Safety and effectiveness of insulin pump therapy in children and adolescents with type 1 diabetes. Diabetes Care 2003; 26(4): 1142-6.
[] [PMID: 12663587]
Petitti DB, Klingensmith GJ, Bell RA, et al. SEARCH for Diabetes in Youth Study Group. Glycemic control in youth with diabetes: the SEARCH for diabetes in Youth Study. 2009; 155(5): 668-72.e1, 3 J Pediatr 2009; 155(5): 668-72.e1, 3. Available from:
[] [PMID: 19643434]
Sivertsen B, Petrie KJ, Wilhelmsen-Langeland A, Hysing M. Mental health in adolescents with Type 1 diabetes: results from a large population-based study. BMC Endocr Disord 2014; 14(83): 83.
[] [PMID: 25303963]
Nansel TR, Gellar L, McGill A. Effect of varying glycemic index meals on blood glucose control assessed with continuous glucose monitoring in youth with type 1 diabetes on basal-bolus insulin regimens. Diabetes Care 2008; 31(4): 695-7.
[] [PMID: 18202243]
Naughton MJ, Ruggiero AM, Lawrence JM, et al. SEARCH for Diabetes in Youth Study Group. Health-related quality of life of children and adolescents with type 1 or type 2 diabetes mellitus: SEARCH for Diabetes in Youth Study. Arch Pediatr Adolesc Med 2008; 162(7): 649-57.
[] [PMID: 18606936]
Williams VSL, Soliman AM, Barrett AM, Klein KO. Review and evaluation of patient-centered psychosocial assessments for children with central precocious puberty or early puberty. J Pediatr Endocrinol Metab 2018; 31(5): 485-95.
[] [PMID: 29649000]
Szalai E, Deák E, Módis L Jr, et al. Early Corneal Cellular and Nerve Fiber Pathology in Young Patients With Type 1 Diabetes Mellitus Identified Using Corneal Confocal Microscopy. Invest Ophthalmol Vis Sci 2016; 57(3): 853-8.
[] [PMID: 26943147]
Sheikh K, Bullock CM, Jiang Y, Ketner SD. Adherence to guidelines for and disparities in diabetes care utilization in Medicaid children. J Pediatr Endocrinol Metab 2008; 21(4): 349-58.
[] [PMID: 18556966]
Kovács K. The relationship between health-awareness and academic achievement on a national representative sample 2018.
Munkácsi B, Papp G, Felszeghy E, Nagy BE, Kovács KE. The associations between mental health, health-related quality of life and insulin pump therapy among children and adolescents with type 1 diabetes. J Pediatr Endocrinol Metab 2018; 31(10): 1065-72.
[] [PMID: 30291785]
Nagy BE, Kovács KE. Egészség-magatartással kapcsolatos attitűdök vizsgálata középiskolás és egyetemista fiatalok körében. Orv Hetil 2017; 158(44): 1754-60.
[] [PMID: 29227147]
Gillani SW, Ansari IA, Zaghloul HA, et al. 2018.
Dømgaard M, Bagger M, Rhee NA, Burton CM, Thorsteinsson B. Individual and societal consequences of hypoglycemia: a cross-sectional survey 2015.
Korbel CD, Wiebe DJ, Berg CA, Palmer DL.
Monaghan M, Horn IB, Alvarez V, Cogen FR, Streisand R. Authoritative parenting, parenting stress, and self-care in pre-adolescents with type 1 diabetes. J Clin Psychol Med Settings 2012; 19(3): 255-61.
[] [PMID: 22350495]
Lewin AB, Heidgerken AD, Geffken GR, et al. The relation between family factors and metabolic control: the role of diabetes adherence. J Pediatr Psychol 2006; 31(2): 174-83.
[] [PMID: 16467317]
Jaser SS. Family interaction in pediatric diabetes. Curr Diab Rep 2011; 11(6): 480-5.
[] [PMID: 21853415]
Dougherty JP. The experience of siblings of children with type 1 diabetes. Pediatr Nurs 2015; 41(6): 279-282, 305.
[PMID: 26837097]
Povey RC, Hallas CN, White DG, Clarke T, Samuel TJ. Children’s beliefs about the impact of their type 1 diabetes on their family and peers: An exploratory study. Pract Diabetes Int 2005; 22: 333-8.
Faulkner MS, Chang LI. Family influence on self-care, quality of life, and metabolic control in school-age children and adolescents with type 1 diabetes. J Pediatr Nurs 2007; 22(1): 59-68.
[] [PMID: 17234498]
Haugstvedt A, Wentzel-Larsen T, Rokne B, Graue M. Psychosocial family factors and glycemic control among children aged 1-15 years with type 1 diabetes: a population-based survey. BMC Pediatr 2011; 11: 118.
[] [PMID: 22185481]
Thomas AM, Peterson L, Goldstein D. Problem solving and diabetes regimen adherence by children and adolescents with IDDM in social pressure situations: a reflection of normal development. J Pediatr Psychol 1997; 22(4): 541-61.
[] [PMID: 9302851]
Helgeson VS, Lopez LC, Kamarck T. Peer relationships and diabetes: retrospective and ecological momentary assessment approaches. Health Psychol 2009; 28(3): 273-82.
[] [PMID: 19450032]
Amblee A. Mode of administration of dulaglutide: implications for treatment adherence. Patient Prefer Adherence 2016; 10: 975-82.
[] [PMID: 27330280]
Glaser NS, Iden SB, Green-Burgeson D, et al. Benefits of an insulin dosage calculation device for adolescents with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2004; 17(12): 1641-51.
[] [PMID: 15645698]
Munkácsi B, Nagy BE, Kovács KE. Cukorbeteg gyermekek együttműködésének vizsgálata a Diabetes Adherencia Kérdőív gyermekváltozatának validálása során.The investigation of diabetes adherence and the validation of the Diabetes Adherence Questionnaire Child Version (DAQ-C). Orv Hetil 2019; 160(29): 1136-42.
[] [PMID: 31303013]
Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J Diabetes Complications 2012; 26(1): 10-6.
[] [PMID: 22226484]
Sheehy S, Cohen G, Owen KR. Self-management of Diabetes in Children and Young Adults Using Technology and Smartphone Applications 2014.

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