The Revised Term of Compliance in Type 1 Diabetes Treatment of Chil- dren and Adolescents – A Mini Review and Evidence for Need of Psycho- Medical Training Workshops

Type 1 diabetes is an unusual disease to treat because of the significant role of patient in his or her own therapy. Children and adolescents, who depend on parental and/or familial support, are in an especially difficult situation: their age and rapidly changing somatic and psychological development introduces great complexity into their ability to self-manage their diabetes in an aware and responsible manner. Management of type 1 diabetes is also extremely difficult for a child’s family support team. Even the most experienced medical teams of pediatricians, nurses, dieticians and psychologists can experience difficulties in effective communication and cooperation when it comes to young patients and their families. This cooperation, commonly understood to be ‘compliance’, refers to the patient’s obedience or willingness to adhere to the doctor’s recommendations. All members of the patient’s treatment team should understand one another, trust in the accuracy of the patient’s ability to self-report, and maintain a high level of motivation – and encourage the patient to stay motivated in continuing his or her treatment plan. The present article includes both a mini-review and the authors’ observations of the complex genesis of compliance in type 1 diabetes treatment in young patients. The gathered data strongly suggest the need for revision and extension of term ‘compliance’ to include all members of the medical team and the patient’s personal support network. For young type 1 diabetes patients, his or her family members, as well as the patient’s doctors and educational nurses, the psychologist is often the most important member of the treating medical team. The authors of the present article therefore propose combined psycho-medical group workshops for strengthening compliance to improve the patients’ motivation for success, as well as better communication and education. The authors also recommend doctors; nurses and dieticians interact with the patient’s psychologist in order to understand individual patient needs. The presented findings, following a pilot psycho-medical workshops for diabetic youth and their parents confirm the potential of idea of ‘group compliance’ (instead patient’s individual compliance) in diabetic treatment in young patients.