Comparison of the expectations of caregivers and children with type 1 diabetes mellitus for independence in diabetes care-related tasks.
OBJECTIVE
Children who are given unsupervised responsibility for their diabetes care prior to developmental and/or emotional readiness may have poorer glycemic control. The purpose of this study was to assess the age-related expectations of children and caregivers for independence in diabetes care-related tasks.


METHODS
A total of 150 participants with type 1 diabetes mellitus (T1DM) receiving multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) were enrolled in this study. All caregivers and participants older than 10 years of age completed questionnaires evaluating the expected age of independence for different diabetes care-related tasks.


RESULTS
The participants expected independence with no direct supervision in most diabetes care-related tasks at a younger age than their caregivers (P<.05). The difference was more prominent for those on CSII compared to MDI (P<.01). There was a positive correlation between the age when caregivers expect independence for most of the diabetes-related tasks and the age at diagnosis, regardless of the use of MDI or CSII (P<.01).


CONCLUSIONS
Children with T1DM expect to assume independence at a younger age than their caregivers do. The younger the children are at diagnosis, the younger they are expected by their caregivers to be independent, especially those on CSII.
Helen DeVos Children's Hospital, Spectrum Health Medical Group, Pediatric Endocrinology, Grand Rapids, Michigan Michigan State University, Grand Rapids, Michigan.
Ayse Pinar
AP
Cemeroglu
Michigan State University, Grand Rapids, Michigan.
Argun
A
Can
Grand Rapids Medical Education Partners (GRMEP), Grand Rapids, Michigan Department of Surgery, Michigan State University, Grand Rapids, Michigan.
Alan T
AT
Davis
Helen DeVos Children's Hospital, Spectrum Health Medical Group, Pediatric Endocrinology, Grand Rapids, Michigan.
Lora
L
Kleis
Helen DeVos Children's Hospital, Spectrum Health Medical Group, Pediatric Endocrinology, Grand Rapids, Michigan Michigan State University, Grand Rapids, Michigan.
Maala S
MS
Daniel
Helen DeVos Children's Hospital, Spectrum Health Medical Group, Pediatric Endocrinology, Grand Rapids, Michigan.
Shannon McKinley
SM
Rapp
Grand Rapids Medical Education Partners (GRMEP), Grand Rapids, Michigan.
Tracy J
TJ
Koehler
D000293:Adolescent; D017028:Caregivers; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D011446:Prospective Studies
D007328:Insulin