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The literature widely reported the psychosocial toll of Type 1 diabetes mellitus (T1DM) on patients, though the family functioning of T1DM patients, particularly siblings, has traditionally obtained far less consideration. This study was framed to investigate the psychosocial adjustments of siblings of children with T1DM and to evaluate the frequencies and the perceived efficacy of coping strategies adopted by siblings. This cross-sectional study included parents (n = 100) and siblings (n = 100) of children with T1DM. Parents completed the following questionnaires: Parenting Stress Index-Short Form, Pediatric Quality of Life Inventory™ Family Impact Module, and Strengths and Difficulties Questionnaire (SDQ), while siblings completed SDQ self-report and kidcope questionnaires. Thirty-eight percent of siblings of children with T1DM reported significant emotional and behavioral problems related to HbA1c level, higher parenting stress, and worse family functioning (p < 0.05). Younger siblings considered social support and distraction the most effective coping strategies, while older siblings perceived adaptive coping as the most effective. Social support and problem-solving were found to be protective factors for better sibling adjustments; meanwhile, better family adjustments were related to social support and cognitive restructuring (p < 0.05). Results demonstrate that siblings of children with T1DM experienced psychosocial maladjustment. Sibling adjustments are family interrelated. Adaptive coping strategies may play a buffer role for siblings and family adjustment. The study highlights the need for comprehensive evaluations of family dynamics and sibling psychosocial functioning to provide appropriate family-centered care. • Siblings of children with T1DM experienced emotional and behavioral problems. • Siblings' psychosocial health is related to disease characteristics and family functioning. • Coping strategies influence sibling adjustment and family functioning. [ABSTRACT FROM AUTHOR]

The aim of the current study was to evaluate the safety and efficacy of initiation protocol for MiniMed ™ 780G system among an Egyptian cohort of young people living with type 1 diabetes (T1D). A prospective single-arm study including 72 participants with T1D. Five days of structured education and training were provided to all users and continuous glucose monitoring (CGM) was initiated on the first day of the training. Users initiated the pump initially in manual mode, with suspend before low feature, for 3 days before shifting to Auto Mode. The mean HbA1c decreased from 8.72 ± 2.01 % to 6.7 ± 0.4 % (p<0.01). Time in range (70–180 mg/dL) substantially improved from 55.24 % ± 10.35 to 81.7 % ± 5.12 % after spending 84 days in auto mode (p<0.001) with 2.03 % of the time spent below 70 mg/dL. Regarding AHCL compatibility, users spent at least 90 % of time in auto mode. Young people with T1D successfully initiated the AHCL system, using a tailored structured on-boarding protocol. Structured stepwise initiation protocol and onboarding steps are important prerequisite for participants' adherence and engagement with the system. Patient education together with optimized pump settings are important predictors of glycemic outcomes. [ABSTRACT FROM AUTHOR]

Background: Inadequate adherence to insulin is a major concern, necessitating the use of reliable and valid metrics for assessing adherence. Up to date, there are no Arabic validated tools assessing adherence to insulin therapy among children with type 1 diabetes (T1DM). Thus, the aim of this study is to evaluate the psychometric properties of an Arabic version of the four-item Morisky Green Levine Medication Adherence Scale (MGLS-4) as a self-reported measure of adherence to insulin among a cohort of Egyptian children with T1DM. Methods: The MGLS-4 was translated using forward and backward translation. The Cronbach's alpha was used to assess reliability. Criterion validity of the scale was tested by examining the correlation coefficients between the compliance score (level of adherence) and the HbA1c levels. Results: A total of 400 patients completed the Arabic version of MGLS-4. 26.25% of the studied cohort was found to be non-adherent to insulin therapy; non-adherent patients were significantly older (P=0.001). Decreased maternal education level, decreased frequency of blood glucose monitoring and prolonged disease duration best predicted the occurrence of non-adherence among the studied cohort. The internal consistency of the current version showed good reliability (Cronbach's alpha = 0.857). The adherence score and adherence level showed very strong correlation with HbA1c level (rho = 0.830, P < 0.001 and rho = 0.808, P < 0.001, respectively). Conclusion: The Arabic version of MGLS-4 showed good reliability and validity as a self-administered tool for assessing adherence to insulin in pediatric patients with T1DM. [ABSTRACT FROM AUTHOR]