RESEARCH DESIGN AND METHODS Data were collected from 101 patients who had type 1 DM and were between the ages of 10 and 18. Five types of adherence behaviors were measured: number of calories consumed per day, frequency of meals, self-monitoring of blood glucose, amount of time between injections and meals, and frequency of exercise.

RESULTS Overall, the patients had poor adherence behaviors in each aspect of DM management, and diabetes control was very poor. Only 25% of patients consumed the ideal daily number of calories (within °"10% of the ideal range), while 48% of patients consumed 10% fewer calories than the suggested ideal daily number of calories. Only 28% of patients consumed the ideal percentage (50% to 60%) of calories from carbohydrates. Approximately 15% of patients consumed more than 60% of their calories from carbohydrates and 30% of their calories from fat. Approximately 30% of patients ate their meals 20 to 40 minutes after injection; some patients ate their meals within 20 minutes after injection (45% in the morning and 33% in the evening). For frequency of meals, most patients (>=90%) ate their regular three meals, three or four times per day; only 18% ate the ideal number of six times per day. For self-monitoring of blood glucose, most patients (>70%) tested their blood sugar twice a day, once in the morning and again in the evening. In terms of frequency of exercise, 48% of patients exercised once per day, and 43% of patients did not exercise at all. Only 7% of patients met the good diabetes control of HbA1c <7%; almost half of the patients had HbA1c greater than 10%.

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