Measuring self‐reported, health‐related, quality of life in adolescents with type 1 diabetes using both generic and disease‐specific instruments

Abstract

Aims: To describe perceived functional health and well‐being and diabetes‐related impact, worry and satisfaction with life in relation to demographic and clinical variables in a population of adolescents with type 1 diabetes. To compare perceived functional health and well‐being between adolescents with diabetes and a group of healthy controls and to analyse the relationship between generic functional health and well‐being and diabetes‐related impact, worry and satisfaction with life. Methods: A total of 130 adolescents were invited to complete the Child Health Questionnaire (CHQ‐CF87) and the Diabetes Quality of Life (DQOL) questionnaire modified for youths. A total of 115 (88.5%) subjects participated in the study; mean age 14.5 y (SD 1.86), mean duration of diabetes 6.99 y (SD 3.77, range 1–16 y), mean HbA1c 9.3% (SD 1.62, range 6.2–14.0%). Forty‐eight percent of the subjects were girls. Results: When compared with healthy adolescents, subjects with diabetes reported a significantly lower degree of general health. The CHQ‐CF87 scales showed that higher age in adolescents with diabetes was associated with lower scores for mental health (p < 0.001), self‐esteem (p < 0.001), behaviour (p= 0.004) and general health (p < 0.001). Findings from the DQOL questionnaire showed that older adolescents were more worried (p < 0.001), perceived a greater impact of diabetes on daily life (p= 0.008) and lower diabetes‐related life satisfaction (p < 0.001). The scores for girls were lower than those for boys in assessment of mental health (p < 0.001), self‐esteem (p= 0.004) and family cohesion (p= 0.002). Girls also reported a greater impact of diabetes (p= 0.028), more worries (p= 0.001) and less satisfaction with life (p= 0.006) than boys. Neither HbA1c nor other clinical variables could sufficiently explain the variations in DQOL or CHQ‐CF87. Conclusions: Health‐related quality of life varied significantly by age and gender, but less so by HbA1c and other clinical variables. Adolescents with diabetes reported a significantly lower degree of general health than that reported by healthy controls. The CHQ‐CF87 is a valuable supplement to DQOL, allowing for comparisons with the general population.

Better cardiorespiratory fitness associated with favourable metabolic control and health-related quality of life in youths with type 1 diabetes mellitus

“…When we compared the youths' HRQoL by gender, we found that boys had better perception of quality of life than girls. This gender difference was confirmed in Graue and Kalyva' researches (9,14). We did not find significant relationship between the HRQoL and the metabolic control.…”

“…We observed controversial results regarding the HRQoL and metabolic control in the literature. Some studies found positive correlation between better HRQoL and good glycemic control (12,14,28), others had no evidence about it (7,9,17). Physical activity is essential to health in people of all ages, but for children plays a key role for their physical and mental health.…”

Diabetes-specific variables associated with quality of life changes in young diabetic people: The type 1 diabetes Registry of Turin (Italy)

“…Nonetheless, associations among QoL and the variables examined in our study were similar to those observed in studies of younger patients. In particular, they showed lower QoL in girls than boys and in older adolescents, and higher QoL in patients using insulin pumps (20)(21)(22)(23)(24). A recent study compared QoL through the KINDL-R questionnaire in diabetic people aged 11-17 with onset of disease at age 4 and lower and in a large control group of non diabetic people, providing evidence of similar scores of QoL in both groups (7).…”

Subjective quality of life, self-esteem and social support in teenagres with endocrinological disturbances

“…Świadomość ograniczeń i ewentualnych skutków w przyszłości dotyczy głównie dalszego kształcenia, wyboru zawodu, podejmowania zadań i ról związanych z wiekiem. Młodzież z cukrzycą ocenia swoje ogólne zdrowie podobnie jak zdrowi rówieśnicy (dobrze kontrolowana cukrzyca wiąże się z dobrą adaptacją), ale wiele poszczególnych objawów choroby współwy-stępuje z gorszym fizycznym i psychospołecznym funkcjonowaniem [28].…”

“…Brak istotnych różnic w zakresie subiektywnej jakości życia z uwagi na płeć jest wynikiem interesującym, zwłaszcza gdy rezultaty niektórych badań wskazują, że dziewczęta uzyskują niższe wyniki w porównaniu z chłopcami [28]. Międzygrupowe analizy porównawcze dowodzą, że młodzież z cukrzycą cechuje wyższy poziom subiektywnej jakości życia, zwłaszcza w porównaniu do badanych z otyłością.…”