Age, Metabolic Control and Type of Insulin Regime Influences Health-related Quality of Life in Children and Adolescents with Type 1 Diabetes Mellitus

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2005 May 6

PMID 15875213

Citations 31

Authors

Verena M Wagner

Esther Muller-Godeffroy

Simone von Sengbusch

Stefan Hager

Ute Thyen

Affiliations

Soon will be listed here.

Abstract

Unlabelled: The effects of illness and treatment of diabetes mellitus extend beyond medical outcomes. We therefore evaluated health-related quality of life (HRQOL) in children (aged 8-12 years) and adolescents (aged 13-16 years) with type 1 diabetes to compare their results with healthy peers and to identify HRQOL determinants. A total of 68 children and adolescents from a tertiary care clinic which specialises in the management of diabetes, completed the generic KINDL-R questionnaire. This instrument for children and adolescents has six dimensions and an additional module assessing condition-related HRQOL. Overall, the HRQOL was not different between patients with type 1 diabetes and healthy controls. In some areas, children and adolescents with diabetes reported a better HRQOL compared to healthy peers: adolescents reported better psychological well-being (P < 0.05) and children higher levels of well-being in the school domain (P < 0.05). In general, children reported a better HRQOL (P < 0.05) than adolescents with type 1 diabetes confirming age-related differences in HRQOL in the general population. Lower HbA1c (<8%) and intensified insulin therapy (>3 injections/day) were associated with a better HRQOL in different domains (P < 0.05). The subscale "chronic illness" showed a better HRQOL (P < 0.001) in children and adolescents with diabetes compared to age-matched controls with other chronic conditions.

Conclusion: Children and adolescents from a paediatric department specialising in diabetes management report good health-related quality of life. Younger age, good metabolic control and intensified insulin therapy are associated with a better health-related quality of life. Dimensions of health-related quality of life appear to play different roles at different ages, emphasising the importance of the multidimensional health-related quality of life concept and the value of age-appropriate self-reports.

Citing Articles

Maintaining a gluten-free diet is associated with quality of life in youths with type 1 diabetes and celiac disease.

Franceschi R, Pertile R, Marigliano M, Mozzillo E, Maffeis C, Candia F Acta Diabetol. 2024; 61(8):987-995.

PMID: 38615127 PMC: 11329396. DOI: 10.1007/s00592-024-02281-6.

Quality of life and physical/psychosocial factors in children and adolescents with orthostatic intolerance.

Shigeyasu Y, Okada A, Fujii C, Tanaka C, Sugihara A, Horiuchi M Biopsychosoc Med. 2023; 17(1):23.

PMID: 37308984 PMC: 10258988. DOI: 10.1186/s13030-023-00278-1.

Relation of Health-Related Quality of Life with Glycemic Control and Use of Diabetes Technology in Children and Adolescents with Type 1 Diabetes: Results from a National Population Based Study.

Bratke H, Biringer E, Margeirsdottir H, Njolstad P, Skrivarhaug T J Diabetes Res. 2022; 2022:8401328.

PMID: 36387938 PMC: 9649325. DOI: 10.1155/2022/8401328.

Relationship among health-related quality of life and global ancestry, clinical and socioeconomic factors in type 1 diabetes in an admixed Brazilian population.

Azulay R, Lago D, Santos G, da Gloria Tavares M, Rodrigues V, Magalhaes M Sci Rep. 2022; 12(1):11060.

PMID: 35773385 PMC: 9246993. DOI: 10.1038/s41598-022-15138-1.

The impact of hypoglycemia on quality of life and related outcomes in children and adolescents with type 1 diabetes: A systematic review.

Coolen M, Broadley M, Hendrieckx C, Chatwin H, Clowes M, Heller S PLoS One. 2021; 16(12):e0260896.

PMID: 34855927 PMC: 8638919. DOI: 10.1371/journal.pone.0260896.

References

Dorchy H, Olinger S . [Well-being of insulin-dependent diabetics. Evaluation of 100 adolescents and young adults in relation to their metabolic control]. Presse Med. 1997; 26(30):1420-4. View

Angold A, Costello E, Worthman C . Puberty and depression: the roles of age, pubertal status and pubertal timing. Psychol Med. 1998; 28(1):51-61. DOI: 10.1017/s003329179700593x. View

Kovacs M, Obrosky D, Goldston D, DRASH A . Major depressive disorder in youths with IDDM. A controlled prospective study of course and outcome. Diabetes Care. 1997; 20(1):45-51. DOI: 10.2337/diacare.20.1.45. View

Guttmann-Bauman I, Flaherty B, Strugger M, McEvoy R . Metabolic control and quality-of-life self-assessment in adolescents with IDDM. Diabetes Care. 1998; 21(6):915-8. DOI: 10.2337/diacare.21.6.915. View

. Epidemiology of severe hypoglycemia in the diabetes control and complications trial. The DCCT Research Group. Am J Med. 1991; 90(4):450-9. View

Ravens-Sieberer U, Bullinger M . Assessing health-related quality of life in chronically ill children with the German KINDL: first psychometric and content analytical results. Qual Life Res. 1998; 7(5):399-407. DOI: 10.1023/a:1008853819715. View

Davis E, Keating B, Byrne G, Russell M, Jones T . Hypoglycemia: incidence and clinical predictors in a large population-based sample of children and adolescents with IDDM. Diabetes Care. 1997; 20(1):22-5. DOI: 10.2337/diacare.20.1.22. View

Bott U, Muhlhauser I, Overmann H, Berger M . Validation of a diabetes-specific quality-of-life scale for patients with type 1 diabetes. Diabetes Care. 1998; 21(5):757-69. DOI: 10.2337/diacare.21.5.757. View

Frank R, Hagglund K, Schopp L, Thayer J, Vieth A, Cassidy J . Disease and family contributors to adaptation in juvenile rheumatoid arthritis and juvenile diabetes. Arthritis Care Res. 1998; 11(3):166-76. DOI: 10.1002/art.1790110304. View

10.

Patrick D, Deyo R . Generic and disease-specific measures in assessing health status and quality of life. Med Care. 1989; 27(3 Suppl):S217-32. DOI: 10.1097/00005650-198903001-00018. View

11.

Laffel L, Connell A, Vangsness L, Goebel-Fabbri A, Mansfield A, Anderson B . General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care. 2003; 26(11):3067-73. DOI: 10.2337/diacare.26.11.3067. View

12.

Eiser C, Morse R . A review of measures of quality of life for children with chronic illness. Arch Dis Child. 2001; 84(3):205-11. PMC: 1718699. DOI: 10.1136/adc.84.3.205. View

13.

Graue M, Wentzel-Larsen T, Hanestad B, Batsvik B, Sovik O . Measuring self-reported, health-related, quality of life in adolescents with type 1 diabetes using both generic and disease-specific instruments. Acta Paediatr. 2003; 92(10):1190-6. View

14.

. Influence of intensive diabetes treatment on quality-of-life outcomes in the diabetes control and complications trial. Diabetes Care. 1996; 19(3):195-203. DOI: 10.2337/diacare.19.3.195. View

15.

Stein R, Jessop D . Relationship between health status and psychological adjustment among children with chronic conditions. Pediatrics. 1984; 73(2):169-74. View

16.

Bullinger M . [Health related quality of life and subjective health. Overview of the status of research for new evaluation criteria in medicine]. Psychother Psychosom Med Psychol. 1997; 47(3-4):76-91. View

17.

Eiser C . Children's quality of life measures. Arch Dis Child. 1997; 77(4):350-4. PMC: 1717360. DOI: 10.1136/adc.77.4.350. View

18.

. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research.... J Pediatr. 1994; 125(2):177-88. DOI: 10.1016/s0022-3476(94)70190-3. View

19.

Grey M, Davidson M, Boland E, Tamborlane W . Clinical and psychosocial factors associated with achievement of treatment goals in adolescents with diabetes mellitus. J Adolesc Health. 2001; 28(5):377-85. DOI: 10.1016/s1054-139x(00)00211-1. View

20.

Hoey H, Aanstoot H, Chiarelli F, Daneman D, Danne T, Dorchy H . Good metabolic control is associated with better quality of life in 2,101 adolescents with type 1 diabetes. Diabetes Care. 2001; 24(11):1923-8. DOI: 10.2337/diacare.24.11.1923. View