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Age, metabolic control and type of insulin regime influences health-related quality of life in children and adolescents with type 1 diabetes mellitus

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Abstract

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.

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Abbreviations

BMI :

body mass index

DCCT :

diabetes control and complications trial

HRQOL :

health related quality of life

QOL :

quality of life

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Acknowledgements

This study was supported by grants from the Association for Support of Rehabilitation Research LVA Schleswig-Holstein-vffr, Germany (Verein zur Förderung der Rehabilitationsforschung). We would like to thank the participating children, adolescents and their parents as well as staff members from the outpatient department of our hospital.

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Correspondence to Verena M. Wagner.

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Wagner, V.M., Müller–Godeffroy, E., von Sengbusch, S. et al. Age, metabolic control and type of insulin regime influences health-related quality of life in children and adolescents with type 1 diabetes mellitus. Eur J Pediatr 164, 491–496 (2005). https://doi.org/10.1007/s00431-005-1681-4

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  • DOI: https://doi.org/10.1007/s00431-005-1681-4

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