Turkiye Klinikleri Journal of Pediatrics

.: ORIGINAL RESEARCH
Correlation Between Patient's Adherence and Glycemic Control in Children with Type 1 Diabetes During the COVID-19 Pandemic: A Cross-Sectional Study
Tip 1 Diyabetli Çocuklarda COVID-19 Pandemisi Sürecinde Hasta Uyumu ve Glisemik Kontrol Arasındaki Korelasyon: Kesitsel Bir Çalışma
Nur ROCHMAHa,b, Muhammad FAIZIa,b, Yuni HISBIYAHa,b, Jeny ROSANINGRUMd, Bambang Subakti ZULKARNAINd, Anang ENDARYANTOa,b, Soetjipto SOETJIPTOa,c
aPost Graduate Study, Faculty of Medicine, Universitas Airlangga, Surabaya, INDONESIA
bFaculty of Medicine, Department of Child Health, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, INDONESIA
cDepartment of Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, INDONESIA
dDepartment of Clinical Pharmacy, Faculty of Pharmacy, Universitas Airlangga, Surabaya, INDONESIA
Turkiye Klinikleri J Pediatr. 2022;31(1):39-44
doi: 10.5336/pediatr.2021-83526
Article Language: EN
Full Text
ABSTRACT
 Objective: The pandemic condition has hampered the health system because of government efforts to limit the spread of the coronavirus disease-2019 (COVID-19). These restrictions can affect the management of children with Type 1 diabetes mellitus (T1DM). We aimed to assess the correlation between patient adherence and glycemic control during early pandemic. Material and Methods: T1DM patients who regularly control to Pediatric Endocrine Outpatient Clinic of Dr. Soetomo Hospital, aged 4-18 years old and whose parents were willing to jjoin this study were included. The sample was randomly collected by phone from July 2nd to 28th, 2020 (during early pandemic). We used the Diabetes Management Questionnaire (DMQ) (parents-reported method for children aged 13 years). The correlation between variables was analyzed by using Pearson correlation test. Results: Thirty patients were included in our study (mean age: 11.70±3.49 years old; the mean DMQ score: 56.33±11.30). The mean (±SD) HbA1c level was 11.35 (1.95) %. The DMQ score consists of 4 sectors, including adherence to insulin use, diet management, physical activity and glycemic monitoring, the means of patient's score vs maximum score as followed (10.00 vs 10.00), (24.83 vs 40.00), (6.87 vs 15), (18.25 vs 35). Unfortunately, the correlation analysis on patient's adherence and HbA1c was not significant (r=-0.231; p=0.164). Conclusion: The correlation between patient's adherence and HbA1c was not significant. Meanwhile, adherence to insulin showed maximal score during early COVID-19 pandemic.

Keywords: T1DM; COVID-19; children; adherence; glycemic control
ÖZET
 Amaç: Pandemik koşullar hükümetin koronavirüs hastalığı2019 (COVID-19)'un yayılımını sınırlamak için girdiği çabalar nedeniyle sağlık sistemini aksatmıştır. Bu kısıtlamalar Tip 1 diabetes mellituslu (T1DM) çocukların yönetimini etkileyebilir. Erken COVID- 19 pandemisi sürecinde hasta uyumu ile glisemik kontrol, glikolize hemoglobin (HbA1c) arasındaki korelasyonu değerlendirmeyi amaçladık. Gereç ve Yöntemler: Yaşları 4 ile 18 arasında değişen, Dr. Soetomo Hastanesi Pediyatrik Endokrin Polkliniğine düzenli olarak kontrole gelen ve ebeveynleri çalışmaya katılmaya istekli olan T1DM tanılı çocuklar çalışmaya alındı. Verileri 2-28 Temmuz 2020 tarihleri arasında (erken pandemi dönemi) telefon görüşmesi yoluyla rastgele örneklem yöntemi ile çevrimiçi olarak topladık. Diyabet Yönetimi Anketini (DYA) (13 yaş çocukların kendilerinin doldurduğu bir anket) kullandık. Değişkenler arasındaki korelasyon Pearson korelasyon testi kullanılarak incelendi. Bulgular: Çalışmamıza 30 hasta alındı (ortalama yaş 11,70±3,49 yıl; ortalama DYA skoru 56,33±11,30). DYA insülin kullanımına uyum, diyet yönetimi, fiziksel aktivite ve glisemik takip olmak üzere 4 bölümden oluşmaktadır. Hasta skorlarının ortalaması vs DYA anketinin her bölümünün maksimum skoru şöyleydi: 10,00 vs 10,00), (24,83 vs 40,00), (6,87 vs 15), (18,25 vs 35). Her DYA bölümünün HbA1c ile korelasyonu şöyleydi: sırasıyla (r=0,026; p=0,893), (r=-0,058; p=0,761), (r=-0,004; p=0,982), (r=0,007; p=0,973). Ortalama (±SS) HbA1c düzeyi 11,35 (1,95) % idi. Maalesef, hasta uyumu ile HbA1cnin korelasyon analizi anlamlı değildi (r=0,231; p=0,164). Sonuç: Çalışmamızda hasta uyumu ile HbA1c arasındaki korelasyon anlamlı değildi. Bu arada, insüline uyum erken COVID-19 pandemisi döneminde maksimum skoru aldı.

Anahtar Kelimeler: T1DM; COVID-19; çocuklar; uyum; glisemik kontrol
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