Life Management Skills Linked to How Children With Type 1 Diabetes Perceive Their Care Technology

Children and adolescents living with type 1 diabetes face a daily balancing act that most adults would find daunting. They count carbohydrates, inject or infuse insulin, scan glucose monitors, and interpret streams of numerical data about their own bodies, all while attending school, playing sports, and navigating friendships. A new cross-sectional correlational study published in BMC Pediatrics by Adnan Batuhan Coşkun, Meral Yaren Gözükara, Aslı Güleşen, and Şenay Çetinkaya suggests that a set of broader everyday competencies, known as life management skills, travels together with how positively young patients perceive the technology designed to help them manage their disease.

The research team recruited 112 children and adolescents aged 10 to 18 years with type 1 diabetes from two public hospitals in Kahramanmaras, Türkiye, between February and May 2026. Participants were enrolled consecutively, meaning that every eligible young patient presenting during the study window was invited to take part, which reduces selection bias compared with convenience sampling. The mean age of the group was 13.18 years with a standard deviation of 2.47 years, and 52.7 percent of the participants were female. Data collection relied on three instruments: a sociodemographic and clinical information form, the Life Management Skills Scale for Children with Type 1 Diabetes, and the Diabetes Technology Scale.

Life management skills in this context refer to more than clinical know-how. The construct captures the practical, organizational, and interpersonal abilities a child uses to run the routine of living with a chronic condition: planning meals, scheduling monitoring, coping emotionally with setbacks, and communicating with family members and healthcare providers. The Diabetes Technology Scale, by contrast, measures perceptions of the devices that have transformed pediatric diabetes care over the past two decades, including continuous glucose monitoring systems, intermittently scanned monitors, insulin infusion pumps, and automated insulin delivery platforms often described as hybrid closed-loop systems.

The headline statistical result is a positive correlation between the two constructs. Perceptions of diabetes technology use correlated with total life management skills at r = .553, with a 95 percent confidence interval spanning 0.409 to 0.670 and a p value below .001. In practical terms, children who scored higher on everyday life management tended to view their glucose monitors, pumps, and scanning devices more favorably. A correlation of this magnitude is considered moderately strong, explaining roughly 30 percent of the shared variance between the two measures, a substantial overlap for behavioral research in pediatric populations.

The analysis went beyond simple correlation. Diabetes management knowledge, one component measured within the study, differed according to paternal education level, with an ANOVA yielding F(3,108) = 3.281, p = .024, and an effect size of η² = 0.084. Knowledge also differed according to diabetic ketoacidosis history, a Kruskal-Wallis test giving H(2) = 6.967, p = .031, ε² = 0.046. Diabetic ketoacidosis, the dangerous metabolic crisis that can arise when insulin levels fall too low, thus emerged as a clinical marker associated with both knowledge and technology perceptions. Meanwhile, Diabetes Technology Scale scores differed according to living arrangement, H(2) = 7.213, p = .027, ε² = 0.048, and again according to ketoacidosis history, H(2) = 7.097, p = .029, ε² = 0.047.

The most technically important step was the multivariable linear regression. In a complete-case analysis of 97 participants, the researchers adjusted for age, diabetes duration, HbA1c, insulin treatment regimen, and glucose monitoring method. Even after accounting for these demographic and clinical covariates, total life management skills remained independently associated with Diabetes Technology Scale scores, with an unstandardized coefficient B = 0.146, standard error 0.026, standardized coefficient β = 0.496, and a 95 percent confidence interval from 0.094 to 0.198, p < .001. The overall model explained 36.3 percent of the variance in technology perceptions, a respectable figure for a behavioral model in this field.

The standardized coefficient deserves attention. A β of 0.496 indicates that life management skills carried roughly half a standard deviation of predictive weight on technology perceptions per standard deviation of change, dominating the adjusted model. HbA1c, the glycated hemoglobin marker that reflects average glucose control over the preceding two to three months, was included as a covariate, as were the insulin regimen, whether multiple daily injections or continuous infusion, and the glucose monitoring method, whether real-time continuous monitoring, intermittently scanned monitoring, or conventional fingerstick testing. The persistence of the association across these adjustments strengthens the case that the relationship is not merely an artifact of clinical severity or device access.

Why might this connection exist? The authors and the broader literature point to several plausible mechanisms. Children with stronger organizational and coping skills may find the demands of operating a glucose sensor or insulin pump less overwhelming, interpreting device alerts as helpful guidance rather than intrusive noise. Conversely, young patients who perceive their technology as reliable and empowering may gain confidence that spills over into other domains of daily self-care, from meal planning to school routines. Technology perceptions and life management skills may also reinforce each other in a feedback loop, each success with the devices building the practical competence needed for the next.

The study’s limitations are clearly stated and matter for interpretation. Because the design is cross-sectional, capturing a single moment in time, the temporal direction of the association cannot be determined. The findings should not be read as evidence that boosting life management skills would improve technology perceptions, nor that better technology perceptions would strengthen life management skills, and certainly not as proof of intervention effectiveness. The sample of 112 participants from two hospitals in a single Turkish province, with a complete-case regression subset of 97, also limits generalizability, and self-reported scales can carry perception biases common to pediatric chronic disease research.

Nevertheless, the implications for pediatric diabetes teams are concrete. Nursing and pediatric specialists who assess a child’s everyday life management abilities may gain useful insight into how that child will respond to continuous glucose monitors, insulin pumps, and hybrid closed-loop systems. The results suggest that supporting the organizational, emotional, and communication skills of young patients, alongside technical training on the devices themselves, could shape the trajectory of how the next generation of diabetes technology is received. As automated insulin delivery becomes standard care for children with type 1 diabetes, understanding which psychological and practical resources help young patients embrace these tools may prove as important as the engineering inside the devices.

Subject of Research: Health

Article Title: Association between life management skills and perceptions of diabetes technology use among children and adolescents with type 1 diabetes: a cross-sectional correlational study

Article References: Coşkun, A. B., Gözükara, M. Y., Güleşen, A., & Çetinkaya, Ş. (2026). Association between life management skills and perceptions of diabetes technology use among children and adolescents with type 1 diabetes: a cross-sectional correlational study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07634-4

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07634-4

Keywords: type 1 diabetes, pediatrics, diabetes technology, life management skills, continuous glucose monitoring, BMC Pediatrics, Association, between, life, management, skills, perceptions