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Adolescent Diabetes Non-Adherence — RACP Paediatrics MCQ

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ModerateEndocrinologyAdolescent Diabetes Non-AdherenceRACP Paediatrics

A 14-year-old girl with type 1 diabetes on an insulin pump has a persistently elevated HbA1c of 80 mmol/mol despite reported good glucose readings on her pump download. The pump download shows minimal glucose data with frequent gaps. What is the most likely explanation?

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Correct answer: E — Non-adherence with pump usage (removing the pump frequently)

In adolescents, the most common reason for discordance between reported/pump glucose readings and HbA1c is non-adherence, including removing the pump for extended periods. This is common during adolescence when psychosocial factors and body image concerns affect diabetes self-management. A non-judgmental, supportive approach is essential.

Reference: ISPAD – 2024 – Diabetes in Adolescence