iIntroduction:/i Type 1 diabetes mellitus (T1DM) is a chronic disease that predominantly affects children and adolescents. Its management requires strict adherence to medical recommendations in order to prevent severe acute and chronic complications. However, during adolescence, therapeutic adherence often becomes challenging due to physical, psychological, and social factors specific to this stage of life. The objective of this study was to determine the prevalence of poor therapeutic adherence among adolescents with T1DM followed in pediatric departments of the University Hospital Center of Dakar and to identify the factors associated with non-adherence. iMethods:/i This was a prospective, descriptive, analytical, and multicenter study conducted over a three-month period (March–April–May 2023) in the pediatric departments of Abass Ndao Hospital Center and Albert Royer National Children’s Hospital in Dakar, Senegal. All patients aged 10 to 18 years with a diagnosis of T1DM for at least three months who attended outpatient consultations during the study period were included. Data were collected at the end of consultations using a pre-established questionnaire. Written informed consent was obtained from all participants and their caregivers. Therapeutic adherence to insulin was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). iResults:/i A total of 106 adolescents were included among 219 children who attended consultations during the study period. The sex ratio was 0.66, and the mean age was 14.61 years. According to the Morisky score, low adherence to insulin therapy was observed in 18.87% of patients, while good adherence was found in 27.36%. Overall, the prevalence of poor therapeutic adherence was 61.32%. Several factors were significantly associated with adherence. Full parental supervision was associated with better adherence compared to minimal parental involvement (p = 0.003). A perceived loss of freedom related to treatment and the presence of treatment-related side effects were significantly associated with poor adherence (p = 0.029 and p = 0.003, respectively). Poor adherence was also associated with diabetes diagnosis disclosure by a general practitioner rather than a pediatrician (p = 0.03). Furthermore, poor therapeutic adherence was significantly correlated with poor glycemic control (p = 0.03). iConclusion:/i This study highlights the importance of considering adolescent-specific factors in the management of type 1 diabetes. Improved understanding of these determinants may contribute to more effective care strategies and better prevention of complications among adolescents living with T1DM.
Mbaye et al. (Fri,) studied this question.