Endocrine Abstracts

Introduction: Insulin, an essential treatment for type 1 diabetes, must be implemented as soon as diabetes is discovered. It helps to ensure glycemic control. Poor therapeutic compliance may be responsible for the development and progression of complications related to glycemic disorders.

Objective of the study: Assess insulin adherence in type 1 diabetes and study the consequences on glycemic control.

Materials and methods: This is a descriptive prospective study in a group of type 1 diabetic patients followed in the endocrinology and metabolic diseases department at the UHC Ibn Rochd in Casablanca from September 2022. The evaluation of therapeutic compliance was evaluated by the Morisky-Green questionnaire “high adhesion if the score is greater than or equal to 8, medium adhesion between 6 and 7 and low adhesion if <6”. Statistical analysis was performed using SPSS 25.

Results: We included 69 patients. The average age was 25 years (+-6.7 years). There is a male predominance with 38 patients (55.1%). Among these patients, 39.1% had a college education level, 29% a high school education level and 7.2% university. The socio-economic level was low in 62 patients (89.9%). The average duration of diabetes was 11.51 years (+-6.4 years). Almost all of our patients were on a basal-bolus regimen (91.3%) including 52 patients (75.4%) on human insulins and 17 patients (24.6%) on insulin analogues. The average number of injections per day was 4.7. The average HbA1c was 10.32% (+- 2.4%). Adherence to insulin was good in 52.2% of cases, medium in 27.5% of cases and low in 20.3% of cases. In bivariate analysis, patients with good treatment compliance had an A1c within the target (P=0.005). In multivariate analysis, patients with poor adherence to treatment were more at risk of microangiopathic complications (P=0.038).

Conclusion: Therapeutic compliance was low in 20.3% of cases, which suggests the importance of therapeutic education of these patients and the need to create specialized education units.