Effect of reward-based motivation on metabolic control in children and adolescents with type 1 diabetes mellitus

The aim of this study was to investigate the impact of reward-based motivation on metabolic control in children and adolescents with type 1 diabetes mellitus (DM). Forty-four children and adolescents (female/male: 21/23 and prepubertal/pubertal: 17/27) with type 1 diabetes mellitus with a mean age of 12.3 ± 2.8 years (8–18 years) and a mean diabetes duration of 4.7 ± 2.7 years (2–11 years) were enrolled in the study. Before the study, patients were informed that three patients who will have the best metabolic control at the end of 1 year would be rewarded. Number of control visits and hypoglycemic episodes, daily insulin requirement and mean hemoglobin A1c (HbA1c) values were compared before and 1 year after study. During the study period, a statistically significant decrease in the mean HbA1c value, number of hypoglycemic attacks, and daily insulin requirement were determined (p < 0.05). Decrease in the mean HbA1c value was significant in both sexes and especially in the pubertal group (p < 0.05). It was observed that the patients had more frequent control visits during the motivation study. While 56 % of the patients had regular control visits before the motivation activity, during the motivation period, regular follow-up ratio improved and increased up to 81 %. The positive impact of motivation has been maintained throughout 6 months after completion of the study. This study showed that motivating activities might provide significant improvement in the metabolic control of children and adolescents with type 1 DM with a more evident effect in the pubertal group.