Self-management practices of type 1 diabetes mellitus

The effective management of Type 1 Diabetes (T1D) involves self-management practices and education about self-monitoring of blood glucose (SMBG) and insulin therapy. Data on self-management practices in India is sparse. The aim of the study was to assess the self-management practices in young subjects with T1D. The frequency and timing of SMBG, the types of insulin used and insulin regimens, and the sites of administration and rotation patterns were analyzed in the study. This was an observational cross-sectional study carried out in young subjects with T1D using a pre designed, pretested questionnaire. Eighty (80) subjects were enrolled; age ranges from 5 to 25 years with a mean duration of T1D of 5 years. HbA1c was less than 8.5% in 47.4% of subjects. Fifty-seven percent monitored SMBG daily and majority monitored only once in the morning and once in the evening. The combination of fasting, pre-lunch, and pre-dinner was most recorded. The types of insulin used are regular, premixed, NPH, and glargine. Majority (62%) used premixed and regular insulin with a thrice-daily regimen. Site rotation was seen in 75.5% of subjects. An association between SMBG and HbA1c was observed. Eighty-six percent of the subjects with SMBG thrice or more in a day had HbA1C of less than 8.5%. The study concludes that SMBG in T1D is underused and highlights the need for educating subjects with T1D and their families further about SMBG, insulin regimens, and the importance of taking insulin diligently as advised by the doctor for better glycemic control.