Determinants of Poor Glucose Monitoring Among Type 1 Diabetic patients aged 15-39 years in India: Role of Psychological Well-Being and Treatment Costs

Abstract

Background: Self-monitoring of blood glucose is central to effective management of type 1 diabetes, yet adherence remains suboptimal among adolescents and young adults. Psychological well-being and treatment-related costs may influence glucose monitoring behaviour, particularly in low- and middle-income settings such as India. Objectives: To assess glucose monitoring behaviour among type 1 diabetic patients aged (15–39 years) and to examine the association of psychological quality of life and treatment-related costs with glucose monitoring practices. Methods: A hospital-based cross-sectional analytical study was conducted among 80 type 1 diabetic patients attending a tertiary care endocrinology outpatient department in northern India. Glucose monitoring behaviour was assessed using the glucose monitoring subscale of the Diabetes Self-Management Questionnaire–Revised (DSMQ-R). Psychological quality of life was measured using the psychological domain of the WHOQOL-BREF. Direct and indirect treatment costs were recorded. Hierarchical multiple linear regression analysis was performed after adjusting for sociodemographic variables. Results: Participants demonstrated low glucose monitoring scores, indicating suboptimal monitoring behaviour. Psychological quality of life was positively associated with glucose monitoring behaviour (β = 0.398,                   p<0.01), while higher indirect treatment costs were associated with poorer monitoring (β = −0.242, p < 0.05). Increasing age was negatively associated with glucose monitoring, whereas higher caregiver education showed a positive association. The final regression model explained 51.0% of the variance in glucose monitoring behaviour. Conclusion: Glucose monitoring behaviour among type 1 diabetic patients in India is influenced by psychological well-being and economic burden. Interventions addressing mental health and reducing treatment-related costs may improve glucose monitoring adherence in this population.