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.

Aims  To investigate psychosocial aspects of continuous subcutaneous insulin infusion (CSII) therapy in children with Type 1 diabetes and to identify relevant and sensitive measures. Methods  We performed a multi‐centre prospective pre‐/post‐study with children (53 girls, 64 boys, age 10.5 ± 3.7 years, mean ± sd) with Type 1 diabetes and their main carer from 18 German diabetic centres. Twenty‐five children aged 8–11 years and 63 adolescents aged 12–16 years and their parents, plus 29 parents of children aged 4–7 years completed standardized questionnaires on generic and diabetes‐specific quality of life (QOL), generic parenting stress, mealtime behaviour, fear of hypoglycaemia and family conflict immediately before and 6 months after transition to CSII. Results  After transition to CSII, diabetes‐specific QOL of children increased significantly (P < 0.001) in all age groups, with moderate to large effect sizes (children aged 4–7 years: Cohen’s effect sized = 1.3; 8–11 years: d = 0.9, adolescents 12–16 years: d = 0.6). Parents reported reduced frequency (P < 0.01, d = 0.4–0.7) and difficulty (P < 0.01, d = 0.3–0.6) of overall parenting stress and decreased worries about hypoglycaemia (P < 0.01, d = 0.4–0.6). Parents of younger children (4–7 years) reported reduced problems with nutrition management (frequency: P < 0.001, d = 1.1; difficulty: P < 0.05, d = 0.7). Conclusions  CSII may have substantial psychosocial benefits. Controlled studies are needed.

The intervention improved metabolic control, diabetes knowledge and diabetes-specific quality of life. We conclude that high-quality diabetes care in a rural area can be provided by a mobile diabetes education and care team.

FLIP&FLAP is an effective child- and family-centred programme. It is currently being established in Northern Germany to test its usefulness in routine care.

The aim of the study was to investigate self‐reported health‐related quality of life (HRQOL) in children and adolescents with myelomeningocele (MMC) and to examine the impact of clinical impairments and limitations in activities of daily living (ADL). Fifty patients (28 females, 22 males) between 8 and 16 years of age (mean age 12y 1mo [SD 2y 4mo]) with MMC from three German paediatric centres and their mothers completed standardized measures on HRQOL (KINDL‐R) and limitations in ADL (Childhood Health Assessment Questionnaire). Lesion level was thoracic in nine, sacral in 25, and lumbosacral in 11 patients. Twenty‐one patients were community walkers, 17 were able to walk in the home, and seven used a wheelchair. Two‐thirds had health problems related to the central nervous system causing current difficulties (eight patients had a shunt, six had hydrocephalus, and 10 had a tethered cord). Patients in the study group reported diminished overall HRQOL compared with norm data, specifically in the dimensions of emotional well‐being, self‐esteem, and peer relations. Adolescents reported diminished HRQOL in the dimension of peer relations. Most medical parameters as well as limitations in ADL were not significantly associated with HRQOL. Our findings confirm the results of studies which dispute a linear inverse association between condition severity and HRQOL and emphasize the importance of peer relations in young patients with MMC.