“Does cost of care influence the glycemic control, psychosocial illness and quality of care among adolescents with type 1 diabetes?: A hospital based cross section study in Mysuru, Karnataka

Abstract

Type-1 Diabetes Mellitus, "a poor cousin of Type-2 Diabetes", is the third commonest pediatric endocrine disease. On an average three new cases of T1DM/100,000 adolescents of 0-14 years are reported from India annually.Objective.To find out the relationship between cost of care and glycemic control, psychosocial illness and quality of life among adolescent with type -1 diabetes. Methods: This cross sectional study was conducted in a tertiary care hospital in Mysore for a period of 6 months. Adolescents in the age group of 11-19 years with T1DM who were on treatment for at least one year were included. Direct and indirect cost incurred in diabetes management was collected from receipts. Glycemic control was assessed with fasting, postprandial blood sugar and HbA1C levels in last 3 investigations. Psycho social illness was assessed by DSM-5 (Diagnostic and Statistical Measure −5) criteria and quality of life was assessed using Health related quality of life questionnaire for Diabetics. Results: Among 50 subjects of type-1 diabetes included in the study, median annual cost of care for was 25,758/and of this 90.9% direct and 9.1% was indirect cost. There was a negative correlation between cost of care and glycemic control. The spending on diabetes care was lower among the subjects with psychosocial illnesses. The quality of life was poor among subjects who spend less on diabetes care. Conclusion: There was a negative correlation between cost of care and glycemic control. Lower cost of care was associated with high burden of psychosocial illness and poor quality of life.

Relationship between the cost of illness and quality of life among adolescents with type 1 diabetes—a mixed method study

“…There wasa positive relationship between the cost of illness and diabetes-specific quality of life; the higher the cost was, the worse the quality of life among the type 1 diabetic adolescents in our study. A study conducted in tertiary care hospitals with 59 type 1 diabetic patients showed that treatment expenses and glycemic control were negatively correlated 8 . There was poor quality of life and an increased burden on individuals with psychosocial illness who spent less on diabetestreatment 8 .…”

“…A study conducted in tertiary care hospitals with 59 type 1 diabetic patients showed that treatment expenses and glycemic control were negatively correlated 8 . There was poor quality of life and an increased burden on individuals with psychosocial illness who spent less on diabetestreatment 8 . The costof treatment and glycemic control wererelated, but the cost andQOL among adolescents with T1DMdepended not only on the cost of treatment but also on education level, income, accessibility to health care services, clean and safe housing, and diet 25 .…”

“…Glycemic control and the cost of treatment were found to be negatively correlated. Furthermore, a lower cost of care was associated with a high burden of psychosocial illness and poor quality of life 8 . It was found that taking medicine is not a problem for patients, but arranging for the money to pay for treatment is a major problem.…”

Shape of Life: A Qualitative Study on the Challenges Posed by Diabetic Students

“…This implies that economic impact is one of the main factors that comes to the family in managing the diabetes of a child. (Kulkarni et al, 2020). The cost of managing diabetes is crucial, such as food and fee-based physical activities, and may arise in an increased financial burden for the child and the family (Zappas & Granger, 2017).…”