Quality of life and glycemic control in adolescents with type 1 diabetes and the impact of an education intervention

Abstract

Objective:To assess quality of life (QoL) and glycemic control in adolescents with type 1 diabetes and to investigate the impact of an educational program.Methods:A quasiexperimental study with nonrandomized experimental and control groups was conducted in which a total of 503 adolescents with type 1 diabetes completed a questionnaire using the Diabetes Quality of Life Instrument for Youth. Adolescents were then assigned to experimental and control groups. The experimental group was subjected to four 120-minute sessions of an educational program over a period of 4 months. Extracted medical chart data included the duration of diabetes, insulin dosage, and most recent hemoglobin A1c levels. Analysis of covariance was used to detect the impact of intervention.Results:The overall mean QoL score (%) was 76.51 ± 9.79, with good QoL in 38% of all adolescents. Poorer QoL was significantly associated with older age (P < 0.001), more hospital admissions in the last 6 months (P = 0.006), higher levels of depression (P < 0.001), poor self-esteem (P < 0.001), and poor self-efficacy (P < 0.001). There was significant deterioration in all domains of QoL in the experimental group after intervention. However, this deterioration was significantly less severe than in the control group. Between-group effects on total knowledge, adherence to exercise, glucose monitoring, treatment, self-efficacy, family contribution to management, glycemic control, and satisfaction with life were significantly in favor of the experimental group.Conclusion:Education intervention for adolescents with type 1 diabetes could be a safeguard against possible deterioration in QoL and glycemic control over time.

Association of physical activity level with depression, anxiety, and quality of life in children with type 1 diabetes mellitus

“…HRQoL may reflect people's capacity and competence to manage their diabetes treatment and achieve treatment goals (17,19,23). Children with poor HRQoL are at risk of psychological problems, reduced compliance and adherence to treatment, as well as poor metabolic control (23).…”

“…Thus, they are at high risk for psychosocial morbidities including depression, heightened anxiety, low health-related quality of life (HRQoL), low self-efficacy, low adherence to treatment, and low metabolic control (13)(14)(15)(16)(17)(18)(19)(20). Depression and low HRQoL may also negatively impact metabolic control or outcomes of T1DM (21)(22)(23)(24).…”

Health related quality of life among children with Type I diabetes, Assiut city, Egypt

“…Abolfotouh et al (2011) [29] in Alexandria, Egypt reported that about three-quarters (74.8%) of adolescents had uncontrolled glucose levels according to the HbA1c level, and only 25.2% were controlled. We reported no significant difference of the QOL scores of children with diabetes according to metabolic control levels.…”

Moving the Journey Towards Independence: Adolescents Transitioning to Successful Diabetes Self-Management

“…There is an increase in psychological distress during these years including poor self-esteem which is correlated with poor quality of life (Abolfotouh, Kamal, El-Bourgy, & Mohamed, 2011), increased parental conflict (C. Dashiff, Vance, Abdullatif, & Wallander, 2009; Ingerski et al, 2010), higher rates of depression and anxiety (Hoey, 2009; Insabella, Grey, Knafl, & Tamborlane, 2007). Adolescents believe their parents are overbearing and controlling (Carroll & Marrero, 2006; Hoey, 2009; Leonard, Garwick, & Adwan, 2005), and often do not want their parents involved (Hanna, Juarez, Lenss, & Guthrie, 2003) despite the benefits shown from increased parental support (Leonard et al, 2005).…”