Demographic and Clinical Correlates of Diabetes-Related Quality of Life among Youth with Type 1 Diabetes

Abstract

Objectives To evaluate the reliability and cluster structure of the Pediatric Quality of Life Inventory Type 1 Diabetes Module 3.0 (PedsQL-T1DM) and associated subscales and to explore the associations between PedsQL-T1DM total score and demographic and clinical characteristics and clinical indicators among a large racially/ethnically diverse cohort of youth with type 1 diabetes. Study design Principal components analysis was conducted on responses from the PedsQL-T1DM child self-report forms completed by SEARCH for Diabetes in Youth study participants aged ≥5 years. Multivariate linear regression models were fit to examine the associations among PedsQL-T1DM total score, demographic and clinical characteristics, and clinical indicators. Results The sample comprised 2602 youth with a mean age of 13.6 ± 4.1 years and a mean T1DM duration of 62.1 ± 47.0 months. Principal components analysis did not support the 5 existing PedsQL-T1DM subscales. In multivariate analyses, the PedsQL-T1DM total score was negatively and significantly associated with younger age (5–7 years), female sex, receiving insulin by injection (vs pump), having parents without a college degree, Medic-aid/Medicare insurance, and having a comorbid medical condition. Youth with poor glycemic control based on their age-specific hemoglobin A1c target values and those with depressive symptoms had significantly lower PedsQL-T1DM scores than their counterparts with good control and no or limited depressive symptoms. Conclusion This study has identified sociodemographic and clinical characteristics of youth with T1DM more likely to experience poor diabetes-specific quality of life. The association of lower PedsQL-T1DM scores with depressive symptoms and poor glycemic control is especially concerning and may be the focus of future interventions and studies.

Diabetes-specific variables associated with quality of life changes in young diabetic people: The type 1 diabetes Registry of Turin (Italy)

“…Nonetheless, associations among QoL and the variables examined in our study were similar to those observed in studies of younger patients. In particular, they showed lower QoL in girls than boys and in older adolescents, and higher QoL in patients using insulin pumps (20)(21)(22)(23)(24). A recent study compared QoL through the KINDL-R questionnaire in diabetic people aged 11-17 with onset of disease at age 4 and lower and in a large control group of non diabetic people, providing evidence of similar scores of QoL in both groups (7).…”

Longitudinal Associations between Sex, Diabetes Self-Care, and Health-Related Quality of Life among Youth with Type 1 or Type 2 Diabetes Mellitus

“…Our ability to assess quality of life associations over time by sex, age and other demographic and clinical variables enables us to build on previous work, 1, 13, 19 . Limitations of our study data, however, include any biases from having a greater representation of younger children/adolescents in the follow-up visits, and the lack of additional psychosocial variables that would have been useful in explaining the study results.…”

“…Lawrence et al examined diabetes-specific HRQL and reported lower diabetes-specific HRQL among females with Type 1 diabetes than males. 1 Although these analyses are cross-sectional, they suggest that adolescent females, in particular, may be at greatest risk for poorer HRQL.…”

“…1–4 Although we know that improvements in diabetes management by adolescents can lead to improvements in quality of life, 5–6 self-care management and good glycemic control are difficult for many adolescents to attain and clearly are influenced by many variables. 2, 7 For example, self-care autonomy and reduced parental involvement have been shown to predict poorer self-care management.…”

Psychosocial Burden and Glycemic Control During the First 6 Years of Diabetes: Results From the SEARCH for Diabetes in Youth Study

“…However, adolescents with type 2 diabetes report poorer QOL than both peers without diabetes (11) and adolescents with type 1 diabetes (12). When adolescents with diabetes experience poorer health-related QOL, they are more likely to experience poorer diabetes management and control and depression (13-14). …”