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**Chapter 17**

**Type I Diabetes in Children: Facilitating Adherence to**

Approximately 1 in every 400 to 600 children has Type I diabetes. The care of children with Type I diabetes involves complex procedures including daily blood glucose testing, dietary monitoring, intensive insulin therapy, and physical activity to maintain metabolic control in the face of pancreatic failure. The aforementioned procedures as well as adjustment of insu‐ lin doses based on blood glucose monitoring are critical areas for adherence to the medical regimen. The work and complexity of maintaining a diabetes regimen can lead to adherence issues for children and their families [4,5]. Adhering to diabetes regimens, however, is relat‐ ed to long-term positive health outcomes. If children do not take care of their diabetes they can experience problems with their vision as well cardiovascular issues and circulation problems. This chapter reviews critical issues for adherence for children and adolescents.

Only about 50% of adults and children with chronic illnesses follow or adhere to their medi‐ cal regimens. Adherence is a very important area of study for adolescents with Type I diabe‐ tes, because managing this disease involves multiple strategies including diet, exercise, and glucose monitoring as well as administering medication [9,10]. The early teenage years also are a peak time in terms of incidence rates for developing diabetes, and puberty is a difficult time to manage insulin levels, because adolescents may have decreased insulin sensitivity and poor self-management skills [11]. In this chapter we use the terms adherence and selfmanagement to discuss a child's diabetes care and how well a child's medical regimen is fol‐ lowed. The terms are similar, but it is important to define self-management as a broader concept that involves diabetes management activities by the child and his or her caregivers. Adherence is often more narrowly defined as following one's medical regimen. Both terms

and reproduction in any medium, provided the original work is properly cited.

© 2013 Nabors and Bartz; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

**Medical Regimens**

http://dx.doi.org/10.5772/52283

**1. Introduction**

Laura Nabors and Jenny Bartz

Additional information is available at the end of the chapter

Ideas for improving adherence also are presented.
