The poor children of the poor: Coping with diabetes control in a resource-poor setting

Poor control and management of type 2 diabetes mellitus at an under-resourced South African Hospital: is it a case of clinical inertia?

“…Generally rural patients have a low level of literacy and therefore the use of a daily diary for selfmonitoring, as well as the inability for patients to purchase their own glucometers and to refrigerate the insulin vials are all huge challenges. The results in a recent study of patients younger than 15 years, with T1DM, living in a rural, low-resourced setting in South Africa, showed that they were not supported by family with their diabetes control 30 while another study showed that 51.4% were poorly controlled with HbA1c levels above 10%. 31 These are real challenges for both health care professionals and patients alike in South Africa.…”

ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes

“…124,134 Research addressing the Health Belief Model in adolescents indicate that beliefs related to the seriousness of diabetes, personal vulnerability to complications, costs of regimen adherence, and beliefs in the efficacy of treatment/mediation beliefs, have been associated with both regimen adherence and glycemic control. [135][136][137][138] Studies have also shown that individuals' personal models of illness belief for diabetes were associated with psychological adjustment and regimen adherence: greater impact of diabetes was related to increased anxiety, while beliefs about the effectiveness of treatment predicted better dietary self-management. 139,140 Personal model beliefs about diabetes were also shown to mediate the relationship between personality variables (emotional stability and conscientiousness) and selfmanagement behaviors.…”

Editor's Choice

“…Three articles [11][12][13] deal with management of diabetes in children and point out the sharp contrast between the status of patients in the public and private sectors. In the public sector children often cope without adult assistance and, lacking a sufficiency of BG test strips, are unable [4] to undertake any more than rudimentary BG monitoring; in the private sector they receive education and dietary and exercise advice and have access to the most up-to-date management techniques.…”