Role of motivational interviewing in type 1 diabetes mellitus with sub optimal glycemic control.

Abstract

Objective: To determine the role of motivational interviewing in better management of diabetes mellitus in children. Study Design: Observational Cross Sectional Study. Setting: Children Hospital & Institute of Child Health Multan. Period: November 2019 to May 2020. Material & Methods: Fifty-six poorly controlled follow up diabetic children of 8 to 15 years of both sexes, with HBA1c more than 10 %were included. Their social status, educational status whether studying or not was noted. All patients were advised subcutaneous Insulin according to weight. All children were counselled and motivated for self-care, problem identification and solution, and proper diabetic management by a team consisting of an endocrinologist, a dietitian, a psychologist and a nurse. Glycemic control was assessed using HbA_1c, at 1^st visit, 3^rd and 6^th month. A decline in HbA1c by ≥1% was considered for good control of DM, while ≤1% decrease was taken as poor control of DM. Data was analyzed by using SPSS version 20. Result: Out of 56 patients. 50%(n=28) were females and ,50%(n=28) were males.42.9 % (n=24) patients were age ranges between 8 to 11.5 years while 57.1%(n=32) more than 11.5 to 15 years, with mean age of 11.8±1.97 years  28.6% diabetic children belonged to lower, 57.1% middle while 14.3% upper socioeconomic status. 69.4%children were going to school while 27.6% were not studying. Good glycemic control was observed in 85.7% diabetic children which is statistically significant (p-value <0.001). Conclusion: Motivational interview proved to be a good tool for the better outcome of diabetic children, who need both knowledge and practical communication for their management regarding behavioral changes, lifestyle issues and self-management. It must be a part of diabetic management programs.