Quality of Life of Children and Adolescents with Type 1 Diabetes in Kuwait

Abstract

Objectives: To evaluate the health-related quality of life (HRQoL) of children and adolescents with type 1 diabetes (T1DM) in Kuwait using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scale and PedsQL 3.0 Diabetes Module, and to identify the risk factors associated with unsatisfactory QoL and their effects on metabolic control. Subjects and Methods: A total of 436 patients (2-18 years) with T1DM (>6 months) and 389 healthy controls, with the parents of both groups, completed the Arabic Generic Core Scale. Those with T1DM also completed the Arabic Diabetes Module. Results: The mean total score of the PedsQL Diabetes Module was 70.2 ± 9.8 reported by children and 59.9 ± 11.1 reported by parents (higher scores indicate better QoL). Young age and long duration of diabetes were associated with poor QoL (p < 0.001). Boys had better total scores than girls in most age groups (70.3 ± 9.3 vs. 52.3 ± 7.2, p < 0.001); however, girls did better than boys regarding treatment barriers and adherence (71.3 ± 7.8 vs. 68.1 ± 6.2, p < 0.005). Higher HbA1c values were associated with lower QoL scores (31.1 ± 5.1 at HbA1c of 15% vs. 82.5 ± 6.1 at HbA1c of 6%, p < 0.0001). Conclusion: HRQoL of children and adolescents with T1DM was consistently poorer than controls. Parents consistently reported poorer QoL scores than their children. We recommend that more support should be provided for the care of children with diabetes in Kuwait.

Validation of the Arabic and Tunisian Arabic version of the KINDL questionnaires for children with diabetes type 1

“…The discrepancy between patient and parent reports is consistent with previous findings [2,17,18]. It is possible that this result reflects that the parents have identified themselves with the child’s diabetes.…”

“…Assessment of HRQOL in clinical practice is important in order to evaluate the course of the disease, early detection of problems, and to determine what type of therapy would be adequate to maintain acceptable metabolic control with less impact on HRQOL in each patient [1]. HRQOL has increasingly been acknowledged as an essential health outcome measure in pediatric medicine [2]. The development and use of pediatric HRQOL measures are important for identifying at-risk children and applying early intervention programs [3].…”

“…No study from the Maghrebin region has been reported. Since there is a great difference in the health care delivery system, religion, culture and family dynamics in different societies, there is a need to do HRQOL studies in different communities [2]. …”

Health related quality of life among children with Type I diabetes, Assiut city, Egypt

“…Also, Nuboer et al (2008) [16] reported that children with diabetes had lower QOL compared to healthy children. [17,18] reported that children with TIDM reported significantly lower total generic QOL than controls. The QOL scores were lower for physical and emotional domains.…”

“…[19] Regarding physical functioning, the majority of children with diabetes had significantly lower physical functioning than healthy peers, this may be due to the developmental changes that occur as school-age children with type I diabetes grow in to adolescence, individual differences in caloric intake related to growth spurts and participation in sports, onset of menses in female adolescents, and adolescent mood swings are all factors contribute to the lower score of physical QOL among children with diabetes. [20] Abdul-Rasoul et al (2013) [18] reported that children with TIDM had lower physical functioning than controls, they explained this result by the demands that diabetes puts on children and their parents to maintain good glycemic control.…”