Dissertation (MSc Pediatric Nursing)Background: Type 1 diabetes mellitus (T1DM) is a rapid growing public health problem in Zanzibar, Tanzania and Africa as well. Its long term complication is serous for both patients and family and may result to considerable burden to health care system. Caregiver’s adequate knowledge on glycemic control and caregiver who have diabetes care experience of 4 to 8 years have been found to be associated with poor glycemic control among children, however these have not been adequate explored in Zanzibar. Objective: To assess children’s blood glucose status and determinants of glycemic control behavior among caregivers of children with type 1 diabetes mellitus in Zanzibar. Materials and Method: Analytical cross sectional study was carried out at the diabetes clinic at Mnazi Mmoja and Abdulla Mzee hospital involving 140 children with their caregivers. Census method was used to include eligible participants in to the study. Interviewer administered questionnaire and laboratory investigation were used to collect data. Data analysis was performed using (SPSS) version 23. Result: About 51.4% of children were early adolescent of age 11 – 12, the mean age was 10.10±1.9. Majority (70.7%) of caregiver were in the age group of 36 –55. Most of the children 117 (83.6%) had high glycated hemoglobin with the mean HbA1c of 11.72 ±2.97. Fifty-four point three percent of caregivers had adequate knowledge while 57.1% had adequate motivation. About 50.7% of respondents had in adequate skills on glycemic control. Majority of the respondents (60%) had negative glycemic control behavior Conclusion: Knowledge, motivation and perceived skills are the important determinants of glycemic control behavior. Caregiver need to have proper knowledge regarding glycemic control to their children especially in blood glucose monitoring, insulin injection and diabetes diet. They need to develop their motivation in term of attitude and social support as well as to improve their skills toward blood glucose control.