Educational Needs and Home-Care Preparedness among Mothers of Children with Type 1 Diabetes Mellitus: A Cross-Sectional Study in Karbala, Iraq

Abstract

Considerable care is reliant upon the skills of the caregiver, as successful management of childhood type 1 diabetes mellitus (T1DM) relies on insulin administration, glucose monitoring, and meal/activity coordination as well as acute glycemic event recognition. Availability of family-centered diabetes education will require identification of specific topics to be addressed in low resource settings. OBJECTIVE: To assess maternal knowledge and reported home-care practices for their children with pediatric Type 1 diabetes mellitus (T1DM) and to develop a prioritized topic list for structured caregiver education. Methods: A descriptive cross sectional study among 100 mothers of children with T1DM who were followed up in the Diabetes and Endocrine Disease Center in Karbala (Iraq) from July to august 2026. Purposive sampling was used for recruiting participants. Sociodemographic characteristics, 13 knowledge items and 35 family-care practices were collected through questionnaires administered by interviewers. Participants were analyzed using SPSS version 26 through descriptive statistics. Results: The mean maternal knowledge score was 2.21 (SD 0.44) on a three-point scale, indicating a moderate degree of knowledge management. For the overall Family-Care Practice Score the mean score was 2.18 (SD 0.41), indicating moderate, variable readiness as well. Knowledge was best for blood glucose monitoring based on finger-prick (83%), recognizing carbohydrate-rich food (78%), insulin deficiency as the basis of T1DM (69%), insulin excess in causing hypoglycemia (74%) and recognition of hypoglycemia symptoms (74%). Large deficits related to primal insulin timing (33% correct), the lifelong nature of T1DM (43%), interpretation of fasting glucose levels (46%), how exercise affects insulin needs (44%), and the role of diet alone in managing T1DM (25%). Conclusion: Mothers had limited understanding and were not adequately prepared to care for the children with diabetic at home . Protocoled, skill-centered family education should focus on individualized insulin-meal coordination (including consideration of timing of insulin dose), glucose interpretation and, related to that both physical-activity planning as well as nutrition, and the managements of hypo- and hyperglycemia. The study recommended that Provide semi-structured caregiver education at diagnosis with scheduled reassessment during follow-up. Concrete Methods in More Detail: We recommend using demonstration, teach-back and return-demonstration for the most common types of insulin administration (e.g., subcutaneous injection or via an external pump), glucose monitoring (e.g., finger-stick blood glucose testing, continuous glucose monitoring), ketone testing when indicated, and emergency management. Provide individual-written action plans for families, not one-size-fits-all insulin-timing or glucose-target statements. Visual Materials Use culturally appropriate visual materials of common Iraqi meals and literacy needs. Schools should be included in hypoglycemia recognition, meal advances, physical-activity contriving, and broadcast of emergencies. Psychosocial screening for and referral of caregiver distress and diabetes-related family burden Assessments of educational programs can be made using caregivers knowledge, observed skills, self-efficacy, episodes of severe hypoglycemia, diabetic ketoacidosis or days spent in target range(if available), time in range where applicable and HbA1c.