Health-related quality of life and treatment preferences in adolescents with type 1 diabetes. The VIPKIDS study (original) (raw)
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Diabetes Research and Clinical Practice, 2014
Multiple daily insulin injections Quality of life Children and adolescents s u m m a r y Aims: The aims of the study were to compare health-related quality of life (HRQoL) in a National Danish population of children and adolescents with type 1 diabetes (T1D) treated with either continuous subcutaneous insulin injection (CSII) or multiple daily insulin injections (MDI), and to investigate whether HRQoL assessments were influenced by treatment duration. Methods: Participants were recruited through the Danish Registry for Diabetes in Childhood and Adolescence. A total of 700 children and adolescents (360 girls), 8-17 years, were included. Of these, 295 were treated with CSII (160 for more than one year) and 405 with MDI (238 for more than one year). Participants and their parents completed the Pediatric Quality of Life Inventory Diabetes and Generic Module. HbA 1c was analyzed centrally. Results: Parents reported children and adolescents on CSII for more than one year to have less diabetes-related symptoms and worry, less problems in communicating diabetes, and better generic functioning compared with those on MDI. Children and adolescents on CSII for more than one year reported less diabetes-related symptoms, but more treatment problems, and better generic functioning in all subscales except social functioning compared with those on MDI for more than one year. Comparing those on CSII and MDI for less than one year, no differences in HRQoL ratings were found, apart from better rating of treatment barriers in the MDI group. Conclusions: This Danish national study on HRQoL in children and adolescents on CSII or MDI showed better HRQoL in children and adolescents on long time CSII, particularly concerning generic HRQoL.
Acta Paediatrica, 2013
To examine health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes on intensive insulin treatment. Methods: All children and adolescents with type 1 diabetes above 8 years of age scheduled for follow-up at 21 paediatric departments in Norway, and one of their parents was invited to describe HRQOL by completing DISABKIDS questionnaires. HRQOL was related to sociodemographic factors (i.e. parental economy, education, marital status and to level of physical activity and disease characteristics, obtained from the Norwegian Childhood Diabetes Registry). Results: Nine hundred and thirty seven (48%) and one of their parents responded. Mean duration of diabetes was 4.9 years (SD 3.3), 51% were girls, 56% used insulin pumps, and 44% used multiple insulin injections, predominantly of long-acting and rapid insulin analogues. Mean HbA1c was 8.5% (SD 1.3). Lower HRQOL scores were significantly associated with higher HbA1c, being a girl and experience of diabetes ketoacidosis. Mothers scored lower than fathers on total score and most subscales. No significant differences in scores were found between users of an insulin pump and multi-injection treatment. Conclusions: Health-related quality of life was related to metabolic control and gender, but not to mode of intensified insulin treatment. Key notes Lower HRQOL scores were significantly associated with higher HbA1c and, being a girl in this population-based study of young people with type 1 diabetes. Experiencing diabetes ketoacidosis was significantly associated to lower HRQOL scores. There were no significant differences in scores between users of insulin pump and multi-injection treatment in this young population on intensive insulin treatment.
Lebanese Medical Journal, 2014
The aim of the study is to investigate the differences in the quality of life (QOL) in Lebanese youths with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) and those using multiple daily injections (MDI) treatment modalities. METHODS : A descriptive, cross-sectional, comparative matched design was used. The sample included 36 adolescents and young adults on one of two treatment modalities (CSII or MDI) and matched for age, gender, and level of education. QOL was measured with the Indiana Diabetes Quality of Life for Youth and latest HbA1C level was recorded. RESULTS : The CSII group had significantly lower HbA1C levels (p < 0.001), and reported better health perception (p = 0.029), more satisfaction with life (p = 0.002), less impact of the disease (p = 0.002), and fewer worries about their disease (p = 0.029), compared to the MDI group. The overall quality of life score was also significantly better in the CSII group than in the MDI group (p = 0.001). CONCLUSIONS : Findings suggest that CSII is associated with better glycemic control and QOL in the Lebanese youth population with type 1 diabetes.
Diabetologia, 2006
Aims/hypothesis: The aim of this study was to test the construct validity of the Diabetes Quality of Life for Youth (DQOLY) questionnaire in a large representative sample of young people with type 1 diabetes mellitus. Methods: The 52-item DQOLY questionnaire was completed by 2,077 adolescent individuals (aged 10-18 years) with type 1 diabetes. Participants were recruited from 22 paediatric diabetes centres in 18 countries across Europe, Asia and North America. HbA 1c levels were determined once and analysed centrally. Results: Exploratory factor analysis generated three possible measurement models of a revised questionnaire, two with four factors and one with six factors, with all models indicating the presence of one satisfaction scale, but with many of the impact and worry scale items either double loading or not loading on any factors. Subsequent confirmatory analysis indicated that compared with the original DQOLY scales, the six-factor solution was the best-fitting model. Conclusions/interpretation: The DQOLY factor structure does not show construct validity in a large, diverse representative sample of young people with type 1 diabetes. However, a revised (short-form) version of the DQOLY is proposed that has improved construct validity, adequate internal consistency, and more precise and hypothesised association with HbA 1c . It is anticipated that this shorter version will enhance the acceptability and clinical utility of the measure, making it more feasible to introduce as part of routine care.
Diabetic Medicine, 2008
Aims The aim of this case-control study was to compare quality of life (QoL) and treatment satisfaction in adults with Type 1 diabetes (T1DM) treated with either continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). Methods Consecutive patients aged between 18 and 55 years, and attending diabetes clinics for a routine visit, completed the Diabetes-Specific Quality-of-Life Scale (DSQOLS), the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the SF-36 Health Survey (SF-36). Case (CSII) and control subjects (MDI) were recruited in a 1 : 2 ratio. Results Overall, 1341 individuals were enrolled by 62 diabetes clinics; 481 were cases and 860 control subjects. Cases had a longer diabetes duration and were more likely to have eye and renal complications. Age, school education, occupation and HbA 1c were similar. Of control subjects, 90% followed glargine-based MDI regimens and 10% used NPH-based MDI regimens. On multivariate analysis, after adjusting for socioeconomic and clinical characteristics, scores in the following areas of the DSQOLS were higher in cases than control subjects: diet restrictions (β = 5.96; P < 0.0001), daily hassles (β = 3.57; P = 0.01) and fears about hypoglycaemia (β = 3.88; P = 0.006). Treatment with CSII was also associated with a markedly higher DTSQ score (β = 4.13; P < 0.0001) compared with MDI. Results were similar when CSII was compared separately with glargine-or NPH-based MDI regimens. Conclusions This large, non-randomized, case-control study suggests quality of life gains deriving from greater lifestyle flexibility, less fear of hypoglycaemia, and higher treatment satisfaction, when CSII is compared with either glargine-based or NPH-based MDI regimens.
Acta bio-medica : Atenei Parmensis, 2003
This study is aimed at answering the question whether the demands of the intensified diabetes management and good metabolic control may influence the Quality of Life (QOL) of adolescents with Type 1 Diabetes (T1D), and that of their parents. Overall, 153 adolescents were involved (78 males, mean age 15.0 +/- 2.3 median age 14.6 years; average diabetes duration 6.5 +/- 3.5 years) from the Regional Centres of the Universities of Chieti and Parma. HbA1c determination was centralized and the adolescents were tested according to the adolescent version of the questionnaire developed by Ingersoll and Marrero on the impact of diabetes, worries about diabetes, satisfaction with life, and health perception. The burden on the family was assessed following a newly constructed questionnaire. The average HbA1c value was 7.7 +/- 1.4% (boys 8.0 +/- 1.4 and girls 7.5 +/- 1.2%). The impact of diabetes was similar for both boys and girls (average scores: 44.68 vs 45.00) with no effect regarding age or...
Quality of life and new devices in the management of type 1 diabetes in children and adolescents
Acta bio-medica : Atenei Parmensis, 2003
Insulin therapy is the cornerstone in treatment of type 1 diabetes in children and adolescents. In order to prevent long-term complication multiple daily injections (MDI) are required. Quality of life is dearly affected by the administrations of 3-4 daily injections with syringe. Insulin pens are new devices realized with the aim of simplifying insulin administration. More recently continuous blood sugar monitoring has become available for clinical studies and its role for better metabolic control and quality of life is now under investigation. The aim of this paper is to review published data on the significance of insulin pen and continuous blood sugar monitoring on quality of life in diabetic children and adolescents.
Background and aims: Aim of this study was to identify subgroups of adults with Type 1 Diabetes Mellitus (T1DM) treated with Continuous Subcutaneous Insulin Infusion (CSII) at higher risk of poor quality of life (QoL). A sample of consecutive patients completed the Diabetes Specific Quality of Life Scale (DSQOLS), investigating the daily burden and restrictions related to diabetes. Lower DSQOLS scores indicate worse QoL perception. Methods and results: The main results were obtained by using a regression-tree technique (RECursive Partitioning and AMalgamation e RECPAM) and multivariate logistic regression. Overall, 472 patients aged between 18 and 55 years were recruited by 43 Italian centers. RECPAM analysis led to the identification of 5 classes characterized by a marked difference a v a i l a b l e a t w w w. s c i e n c e d i r e c t. c o m j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / n m c d Nutrition, Metabolism & Cardiovascular Diseases (2010) 20, 7e14 in QoL. Male patients not reporting episodes of ketoacidosis and using CSII for >2 years had the lowest likelihood of scoring in the lower tertile of the DSQOLS summary score, and thus represented the reference category. Patients who reported !1 ketoacidosis episodes (OR Z 5.4; 95% CI 2.4e12.1) and female patients with a duration of diabetes of <10 years (OR Z 5.9; 95% CI 2.6e13.5) had the highest likelihood of reporting poor QoL, while females with longer diabetes duration (OR Z 2.4; 95% CI 1.3e4.7) and males treated with CSII for 2 years (OR Z 2.2; 95% CI 1.1e4.6) showed a twofold risk of poor QoL. Patient age, diabetic complications and civil status were globally predic-tive variables associated with poor QoL. Conclusion: We identified subgroups of T1DM individuals treated with CSII showing a major impairment in QoL. Specific strategies are needed to help the patient cope with this therapeutic modality, especially during the initial phase of treatment.
Research Square (Research Square), 2022
Background: Living with type-I diabetes mellitus (T1DM) presents children and adolescents with various daily challenges associated with disease management, including signi cant lifestyle changes due to intensive therapeutic exogenous insulin regimes, the need for dietary restrictions, regular exercise, and frequent biochemical marker monitoring. This study aimed at determining diabetes related quality of life (DRQoL) and factors in uencing quality of life in Indian children and adolescents with T1DM. Methods: Three hundred seventy-nine randomly selected children and adolescents with T1DM were assessed using Pediatric quality of life inventory 3.2 diabetes module. Mean scores of DRQoL according to sociodemographic factors, and clinical variables were assessed by an independent sample t test, or ANOVA according to the characteristics of analyzed variables. Paired sample t-test was used to compare children's and adolescents' self-report with caregivers' report. Multivariable linear regression was used to identify the signi cant predictors of DRQoL. Result: The total score of the PedsQL Diabetes Module self-report were found to be 83.77±11.11 for the 5-12 years old and 80.27±13.52 for the 13-18 years old. Patients who attended education (β =-0.134, p= 0.013) and mothers of the patients being educated (β=0.300, p<0.001), and having insulin injection by primary care givers (β = 0.136, p=0.050) were positive determinants of DRQoL; while not attending diabetic education (β =-0.129, p=0.014) and an increase in the mean fasting blood sugar (FBS) (β =-0.130, p=0.016) were found to be negative determinants that explain 20.3% of the variability of total DRQoL scores of children and adolescents (R 2 =0.203, F(20,312)= 5.225, p<0.001). Conclusions: the quality-of-life score for children and adolescents with T1DM in Ethiopia was not su ciently good. The educational status of patients, mothers' educational status, fathers' occupation, type of individual administering insulin medication, attending diabetes health education and mean fasting blood sugar were found to be determinants of DRQoL.