The Role of Parental Self-Efficacy, Capability Well-Being and Electronic Health Literacy in Pediatric Diabetes Management: Insights from a Longitudinal Analysis of Glucose Sensor Data

OBJECTIVES: The aim of this study was to assess the sensor wearing habits of children with type 1 diabetes mellitus (T1DM) using longitudinally collected glucose sensor data and to analyse the association of disease control with parental characteristics.

METHODS: An online cross-sectional study was conducted involving parents and their children aged 8-14 with T1DM using glucose sensor in an university-based pediatric diabetes centre. Standard measurements were used to assess parents’ self-efficacy for their child’s diabetes management (PSESDM), electronic health literacy (eHEALS), and capability well-being (ICECAP-A). Glucose values were obtained for a 180-day period prior to the cross-sectional survey, and the average percentage of sensor wear time (% of total time) and time spent in the therapeutic target range (TIR; 3.9-10.0 mmol/L) were determined.

RESULTS: Altogether 84 children (47.6% girls) and parent (82.1% women) dyads were involved, the children’s mean age was 11.9 years (SD=1.8; range 8-15). During the 180-day period studied, childrens’ mean glucose value was 9.33 mmol/L (SD=2.13; range 6.89-20.59), the average sensor wear time was 75.8% (SD=21.3; range 19.0-98.6), and the average TIR was 61.6% (SD=14.9; range 26.6-84.4). There was a moderate negative correlation between parental PSESDM and the child's 180-day average glucose value (r=0.382, p<0.05), and a strong positive correlation with the TIR (r=0.508, p<0.05). Furthermore, the parental ICECAP-A (r=0.242, p<0.05) and eHEALS (r=0.259, p<0.05) were also moderately correlated with the TIR.

CONCLUSIONS: This study provides baseline data on children with T1DM using a glucose sensor. The results also highlight the key role of parents in the effective management of pediatric diabetes. Children whose parents are more confident in diabetes management, have higher electronic health literacy and generally better well-being have better disease control and outcomes.