Educational Level of Parents as a Determinant of Effective Type1 Diabetes Crisis Management at Home

Abstract

Background: Type 1 diabetes mellitus (T1DM) is a lifelong disease. Despite treatment advances such as continuous glucose monitoring systems (CGMS) and optimized insulin delivery methods that have greatly improved diabetes management, acute complications including hypoglycemia and diabetic ketoacidosis (DKA) remain among the leading causes of morbidity and hospitalization in children. Diabetes education programs are not easily accessible in many households, and language barriers and limited communication may hinder parents from effectively educating their children about diabetes. These challenges contribute to gaps in symptom recognition and hinder effective crisis intervention.

Objective: To evaluate effect of parental educational level on effective crisis management of type 1Diabetes at home.

Methods: A cross-sectional study was conducted among 384 parents of children with T1DM attending clinics in Tabuk, Saudi Arabia. Demographic data, parental education, awareness of hypoglycemia and DKA symptoms, and emergency responses were collected using a structured Arabic questionnaire. Chi square tests and logistic regression analyses were used to identify predictors of correct management.

Results: Most parents recognized hypoglycemia symptoms such as sweating (64.8 percent), but fewer recognized convulsions (27.6 percent). For DKA, awareness was highest for polyuria (64.8 percent) and thirst (59.4 percent), and lower for acetone breath (36.5 percent). Correct responses to hypoglycemia were reported by 77.2 percent of university educated parents and 88.1 percent of postgraduate parents, compared with 68.6 percent of parents with general education. Logistic regression showed that higher parental education was significantly associated with correct crisis management (odds ratio 2.10, 95 percent confidence interval 1.20 to 3.65, p = 0.01). Maternal postgraduate education was the strongest predictor of appropriate responses to both hypoglycemia and DKA.

Conclusion: Parental educational level is a key predictor of successful management of acute crises in pediatric diabetes. Organized workshops that address cultural and linguistic needs could help reduce current disparities. Interactive digital support tools, user friendly educational materials, community-based programs, peer support groups, and regular follow ups may also strengthen parental engagement and create a more supportive environment for families.