This original research was presented by Dr.Jothydev Kesavadev and team at the 25th Annual Meeting of American Association of Clinical Endocrinologists(AACE) in May at Orlando, Florida, USA.

Type 1 diabetes being a challenging metabolic disorder, with majority of patients failing to achieve glycemic goals, we assessed multiple determinants which could predict success and failure of type 1 diabetes care in Kerala over a period of 6-12 months. The multidisciplinary diabetes team specialised in diabetes care at our center were assigned the task of identifying patient characteristics unique to type 1, characteristics of parents of children with diabetes, socio economic factors, influence of level of education, impact of job and lifestyle of parents, support at school/college, role of sibling and their impact on overall diabetes control.

Our diabetes team could identify the following predictors of success enumerated in descending order:

a. Educational status of the mother or father

b. Motivation and willingness to periodically attend diabetes education

c. Disease known to family, friends and teachers

d. Affection and care from an elder sibling

e. Affordability to procure newer devices

f. Accepting the disease

Predictors of failure in descending order include the following:

a. Getting attracted to magical remedies and alternate therapies

b. Anxiety, depression and mood swings

c. Parents unwilling to understand the severity and intricacies of type 1 diabetes

d.Those parents repeatedly requesting for oral medications and lesser number of injections

The multidisciplinary team managing type 1 diabetes children at our center prepared a score card incorporating these factors which could help identify those at risk of treatment failure. This in turn helped the team overcome the challenges managing type 1 diabetes patients and improve treatment outcomes. Treatment of type 1 diabetes has always been a challenge. The reasons for failure are multiple and vary from one region to the other. Identifying the risk factors with the help of a T1D score card will help overcome psycho social and cultural challenges which otherwise limits the longevity of type 1 kids.