Abstract
Background: This study aimed to evaluate the health-related quality of life (HRQoL) of adolescents with type 1 diabetes (T1DM) on the basis of the pediatric quality of life inventory™ (PedsQL™) generic and diabetes-specific modules, and to compare it to that of healthy peers.
Methods: This retrospective case-control study involved 650 participants between ages of 13 and 19 years including 296 adolescents with T1DM from four diabetes centers and 354 healthy peers matched for age and gender from three different cities of the country. Participants completed the validated PedsQL™ for assessing the HRQoL. The analysis included an independent t-test to compare the means of the total and subscales of the PedsQL™ between boys and girls as well as between a healthy group and a group with T1DM. Gender differences in exercise, insulin therapy modalities were evaluated with the Pearson χ2-test.
Results: Adolescents with T1DM have similar HRQoL in all domains when compared to their healthy counterparts. Females report worse HRQoL regardless of the presence of the disease. Insulin pump therapy facilitates better glycemic control and HRQoL. Regular exercise positively correlates with the generic HRQoL in both groups; however, it has no relationship with glycemic control.
Conclusions: Optimal metabolic control and improved HRQoL are the eventual goals of diabetes management. Despite the difficulties, adolescents with diabetes can manage their disease well and live normal lives, similar to their healthy peers. Although diabetes-related problems exist, it seems that regular exercise and staying physically active, as well as promoting insulin pump therapy where it is applicable are related to favorable HRQoL.
Acknowledgments
This research was partially carried out with the contribution of the Workgroup for Health Sciences, Center of Excellence of Applied Materials Science and Nano-Technology at the University of Miskolc.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Kiess W, Gorski T, Penke M, Klamt S, Kapellen TM. Diabetes mellitus in children and adolescents – a global epidemic which has become neglected. J Pediatr Endocrinol Metab 2015;28:247–50.10.1515/jpem-2015-0900Search in Google Scholar
2. Patterson CC, Dahlquist GG, Gyürüs E, Green A, Sotész Gy, et al. Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet 2009;373:2027–33.10.1016/S0140-6736(09)60568-7Search in Google Scholar
3. Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 1997;38:21–37.10.2307/2955359Search in Google Scholar
4. Bond J. Self-rated health status as a predictor of death, functional and cognitive impairment: a longitudinal cohort study. Eur J Ageing 2006;3:193–206.10.1007/s10433-006-0039-8Search in Google Scholar
5. Morris AD, Boyle DI, McMahon AD, Greene SA, MacDonald TM, et al. Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus: the DARTS/MEMO Collaboration: Diabetes Audit and Research in Tayside Scotland: Medicines Monitoring Unit. Lancet 1997;350:1505–10.10.1016/S0140-6736(97)06234-XSearch in Google Scholar
6. Craig ME, Handelsman P, Donaghue KC, Chan A, Blades B, et al. (NSW/ACT HbA(1c) Study Group). Predictors of glycaemic control and hypoglycaemia in children and adolescents with type 1 diabetes from NSW and the ACT. Med J Aust 2002;177:235–8.10.5694/j.1326-5377.2002.tb04754.xSearch in Google Scholar PubMed
7. Frank MR. Psychological issues in the care of children and adolescents with type 1 diabetes. Paediatr Child Health 2005;10:18–20.Search in Google Scholar
8. Cameron FJ. The impact of diabetes on health-related quality of life in children and adolescents. Pediatr Diabetes 2003;4:132–6.10.1034/j.1399-5448.2003.00019.xSearch in Google Scholar PubMed
9. Sawyer MG, Reynolds KE, Couper JJ, French DJ, Kennedy D, et al. A two-year prospective study of the health-related quality of life of children with chronic illness: the parent’s perspective. Qual Life Res 2005;14:395–405.10.1007/s11136-004-0786-ySearch in Google Scholar PubMed
10. Naughton MJ, Ruggiero AM, Lawrence JM, Imperatore G, Klingensmith GJ, et al. Health-related quality of life of children and adolescents with type 1 or type 2 diabetes mellitus: SEARCH for Diabetes in Youth Study. Arch Pediatr Adolesc Med 2008;162:649–57.10.1001/archpedi.162.7.649Search in Google Scholar PubMed
11. Frøisland DH, Graue M, Markestad T, Skrivarhaug T, Wentzel-Larsen T, et al. Health-related quality of life among Norwegian children and adolescents with type 1 diabetes on intensive insulin treatment: a population-based study. Acta Paediatr 2013;102:889–95.10.1111/apa.12312Search in Google Scholar PubMed
12. Laffel LM, Conelli A, Vangsness L, Goebel-Fabbri A, Mansfield A, et al. General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict. Diabetes Care 2003;26:3067–73.10.2337/diacare.26.11.3067Search in Google Scholar PubMed
13. Emmanouilidou E, Galli-Tsinopoulou A, Karavatos A, Nousia-Arvanitakis S. Quality of life of children and adolescents with diabetes of Northern Greek origin. Hippokratia 2008;12:168–75.Search in Google Scholar
14. Ausili E, Tabacco F, Focarelli L, Padua L, Crea F, et al. Multidimensional study on quality of life in children with type 1 diabetes. Eur Rev Med Pharmacol Sci 2007;11:249–55.Search in Google Scholar
15. de Wit M, Delemarre-van de Waal H, Bokma JA, Haasnoot K, Houdijk MC, et al. Self-report and parent-report of physical and psychosocial well-being in Dutch adolescents with type 1 diabetes in relation glycemic control. Health Qual Life Outcomes 2007;5:10.10.1186/1477-7525-5-10Search in Google Scholar PubMed PubMed Central
16. Speight J, Reaney MD, Barnard KD. Not all roads lead to Rome— a review of quality of life measurement in adults with diabetes. Diabet Med 2009;26:315–27.10.1111/j.1464-5491.2009.02682.xSearch in Google Scholar PubMed
17. Hanberger L, Ludvigsson J, Nordfeldt S. Health-related quality of life in intensively treated young patients with type 1 diabetes. Pediatr Diabetes 2009;10:374–81.10.1111/j.1399-5448.2008.00496.xSearch in Google Scholar PubMed
18. Kalyva E, Malakonaki E, Eiser C, Mamoulakis D. Health-related quality of lie (HRQoL) of children with type 1 diabetes mellitus (DM): self and parental perception. Pediatr Diabetes 2011;12:34–40.10.1111/j.1399-5448.2010.00653.xSearch in Google Scholar PubMed
19. The Diabetes Control and Complications Trial Research Group. Influence of intensive diabetes treatment on quality-of-life outcomes in the diabetes control and complications trial. Diabetes Care 1996;19:195–203.10.2337/diacare.19.3.195Search in Google Scholar PubMed
20. Abaci A, Atas A, Unuvar T, Demir K, Bober E, et al. A comparison of multiple daily insulin therapy with continuous subcutaneous insulin infusion therapy in adolescents with type 1 diabetes mellitus: a single-center experience from Turkey. J Pediatr Endocrinol Metab 2009;22:539–45.10.1515/JPEM.2009.22.6.539Search in Google Scholar PubMed
21. Misso ML, Egberts KJ, Page M, O’Connor D, Shaw J. Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus. Cochrane Database Syst Rev 2010;20:CD005103.10.1002/14651858.CD005103Search in Google Scholar
22. Giannini C, de Giorgis T, Mohn A, Chiarelli F. Role of physical exercise in children and adolescents with diabetes mellitus. J Pediatr Endocrinol Metab 2007;20:173–84.10.1515/JPEM.2007.20.2.173Search in Google Scholar
23. American Diabetes Association. Physical activity/exercise and diabetes. Diabetes Care 2004;27(Suppl 1):S58–62.10.2337/diacare.27.2007.S58Search in Google Scholar
24. Riddell MC, Miadovnik L, Simms M, Li B, Zisser H. Advances in exercise, physical activity, and diabetes mellitus. Diabetes Technol Ther 2013;15(Suppl 1):S96–106.10.1089/dia.2013.1511Search in Google Scholar PubMed
25. Varni JW, Seid M, Rode CA. The PedsQL™: measurement model for the pediatric quality of life inventory. Med Care 1999;37:126–39.10.1097/00005650-199902000-00003Search in Google Scholar PubMed
26. Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001;39:800–12.10.1097/00005650-200108000-00006Search in Google Scholar PubMed
27. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psycometrika 1951;16:297–334.10.1007/BF02310555Search in Google Scholar
28. Berkes A, Pataki I, Kiss M, Kemény C, Kardos L, et al. Measuring health-related quality of life in Hungarian children with heart disease: psychometric properties of the Hungarian version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales and the Cardiac Module. Health Qual Life Outcomes 2010;8:14.10.1186/1477-7525-8-14Search in Google Scholar PubMed PubMed Central
29. Varni JW, Burwinkle TM, Jacobs JR, Gottschalk M, Kaufman F, et al. The PedsQL in type 1 and type 2 diabetes. Reliability and validity of the pediatric quality of life inventory generic core scales and type 1 diabetes module. Diabetes Care 2003;26:631–37.10.2337/diacare.26.3.631Search in Google Scholar PubMed
30. Nansel TR, Weisberg-Benchell J, Wysocki T, Laffel L, Anderson B. Quality of life in children with type 1 diabetes: a comparison of general and diabetes-specific measures and support for a unitary diabetes quality-of-life construct. Diabet Med 2008;25:1316–23.10.1111/j.1464-5491.2008.02574.xSearch in Google Scholar PubMed PubMed Central
31. Lukács A, Simon N, Varga B, Kiss-Tóth E, Barkai L. Hungarian adaptation of the Pediatric Quality of Life Inventory™ 3.0 Diabetes Module. Orv Hetil 2011;152:1837–42.10.1556/OH.2011.29208Search in Google Scholar PubMed
32. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2012;35:S64–71.10.2337/dc12-s064Search in Google Scholar PubMed PubMed Central
33. Hesketh KD, Wake MA, Cameron FJ. Health-related quality of life and metabolic control in children with type 1 diabetes: a prospective cohort study. Diabetes Care 2004;27:415–20.10.2337/diacare.27.2.415Search in Google Scholar PubMed
34. Upton P, Eiser C, Cheung I, Hutchings HA, Jenney M, et al. Measurement properties of the UK-English version of the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales. Health Qual Life Outcomes 2005;3:22.10.1186/1477-7525-3-22Search in Google Scholar
35. Wagner VM, Müller-Godeffroy E, von Sengbusch A, Hager S, Thyen U. Age, metabolic control and type 1 of insulin regime influences health-related quality of life in children and adolescents with type 1 diabetes mellitus. Eur J Pediatr 2005;164:491–6.10.1007/s00431-005-1681-4Search in Google Scholar
36. Wagner JA, Abbott G, Lett S. Age related differences in individual quality of life domains in youth with type 1 diabetes. Health Qual Life Outcomes 2004;2:54.10.1186/1477-7525-2-54Search in Google Scholar
37. Graue M, Wentzel-Larsen T, Hanestad BR, Båtsvik B, Søvik O. Measuring self-reported, health-related quality of life in adolescents with type 1 diabetes using both generic and disease-specific instruments. Acta Peadiatr 2003;92:1190–6.10.1111/j.1651-2227.2003.tb02483.xSearch in Google Scholar
38. Bisegger C, Cloetta B, von Rueden U, Abel T, Ravens-Sieberer U. Health-related quality of life: gender differences in childhood and adolescence. Soz Praventivmed 2005;50:281–91.10.1007/s00038-005-4094-2Search in Google Scholar
39. Michel G, Bisegger C, Fuhr DC, Abel T; KIDSCREEN Group. Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Qual Life Res 2009;18:1147–57.10.1007/s11136-009-9538-3Search in Google Scholar
40. Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J Pediatr 1994;125:177–88.10.1016/S0022-3476(94)70190-3Search in Google Scholar
41. Hoogma RP, Hammond PJ, Gomis R, Kerr D, Bruttomesso D, et al. Comparison of the effects of continuous subcutaneous insulin infusion (CSII) and NPH-based multiple daily insulin injections (MDI) on glycaemic control and quality of life: results of the 5-nations trial. Diabet Med 2005;23:141–7.10.1111/j.1464-5491.2005.01738.xSearch in Google Scholar PubMed
42. Grey M, Boland EA, Yu C, Sullivan-Bolyai S, Tamborlane WV. Personal and family factors associated with quality of life in adolescents with diabetes. Diabetes Care 1998;21: 909–14.10.2337/diacare.21.6.909Search in Google Scholar PubMed
43. Lau CY, Qureshi AK, Scott SG. Association between glycaemic control and quality of life in diabetes mellitus. J Postgrad Med 2004;50:189–93.Search in Google Scholar
44. Santiprabhob J, Kiattisakthavee P, Likitmaskul S, Chaichanwattanakul K, Wekawanich J, et al. Glycemic control, quality of life and self-care behavior among adolescents with type 1 diabetes who attended a diabetes camp. Southeast Asian J Trop Med Public Health 2012;43:172–84.Search in Google Scholar
45. Tsalikian E, Mauras N, Beck RW, Tamborlane WV, Janz KF, et al. Impact of exercise on overnight glycemic control in children with type 1 mellitus. J Pediatr 2005;147:528–34.10.1016/j.jpeds.2005.04.065Search in Google Scholar PubMed PubMed Central
46. Kimm SY, Glynn NW, Kriska AM, Barton BA, Kronsberg SS, et al. Decline in physical activity in black and white girls during adolescence. N Engl J Med 2002;347:709–15.10.1056/NEJMoa003277Search in Google Scholar PubMed
©2016 by De Gruyter
Articles in the same Issue
- Frontmatter
- Original Articles
- Translation and psychometric properties of the Persian version of self-management of type 1 diabetes for adolescents
- Generic and disease-specific quality of life in adolescents with type 1 diabetes: comparison to age-matched healthy peers
- Relationship between HOMA-IR and serum vitamin D in Chinese children and adolescents
- Low 25-hydroxyvitamin D level is not an independent risk factor for hepatosteatosis in obese children
- Pediatric thyroid nodules: ultrasonographic characteristics and inter-observer variability in prediction of malignancy
- Frequency of thyroid status monitoring in the first year of life and predictors for more frequent monitoring in infants with congenital hypothyroidism
- Biochemical, radiological, and genetic characterization of congenital hypothyroidism in Abu Dhabi, United Arab Emirates
- High prevalence of DUOX2 mutations in Japanese patients with permanent congenital hypothyroidism or transient hypothyroidism
- Children with severe Osteogenesis imperfecta and short stature present on average with normal IGF-I and IGFBP-3 levels
- Association between physical activity and bone in children with Prader-Willi syndrome
- CNDP1 genotype and renal survival in pediatric nephropathies
- 17-Hydroxyprogesterone responses to human chorionic gonadotropin are not associated with serum anti-Mullerian hormone levels among adolescent girls with polycystic ovary syndrome
- Near-final height in 82 Chinese patients with congenital adrenal hyperplasia due to classic 21-hydroxylase deficiency: a single-center study from China
- Case Reports
- Sertoli cell only syndrome with ambiguous genitalia
- Childhood parathyroid adenoma: a rare but important cause of nephrolithiasis
- A unique case of growth hormone and human chorionic gonadotropin treatment in a 45,X male with Y: autosome translocation and literature review
- Propionic acidemia: a Turkish case report of a successful pregnancy, labor and lactation
- Unusual phenotype of congenital adrenal hyperplasia (CAH) with a novel mutation of the CYP21A2 gene
- Central diabetes insipidus as a very late relapse limited to the pituitary stalk in Langerhans cell histiocytosis
Articles in the same Issue
- Frontmatter
- Original Articles
- Translation and psychometric properties of the Persian version of self-management of type 1 diabetes for adolescents
- Generic and disease-specific quality of life in adolescents with type 1 diabetes: comparison to age-matched healthy peers
- Relationship between HOMA-IR and serum vitamin D in Chinese children and adolescents
- Low 25-hydroxyvitamin D level is not an independent risk factor for hepatosteatosis in obese children
- Pediatric thyroid nodules: ultrasonographic characteristics and inter-observer variability in prediction of malignancy
- Frequency of thyroid status monitoring in the first year of life and predictors for more frequent monitoring in infants with congenital hypothyroidism
- Biochemical, radiological, and genetic characterization of congenital hypothyroidism in Abu Dhabi, United Arab Emirates
- High prevalence of DUOX2 mutations in Japanese patients with permanent congenital hypothyroidism or transient hypothyroidism
- Children with severe Osteogenesis imperfecta and short stature present on average with normal IGF-I and IGFBP-3 levels
- Association between physical activity and bone in children with Prader-Willi syndrome
- CNDP1 genotype and renal survival in pediatric nephropathies
- 17-Hydroxyprogesterone responses to human chorionic gonadotropin are not associated with serum anti-Mullerian hormone levels among adolescent girls with polycystic ovary syndrome
- Near-final height in 82 Chinese patients with congenital adrenal hyperplasia due to classic 21-hydroxylase deficiency: a single-center study from China
- Case Reports
- Sertoli cell only syndrome with ambiguous genitalia
- Childhood parathyroid adenoma: a rare but important cause of nephrolithiasis
- A unique case of growth hormone and human chorionic gonadotropin treatment in a 45,X male with Y: autosome translocation and literature review
- Propionic acidemia: a Turkish case report of a successful pregnancy, labor and lactation
- Unusual phenotype of congenital adrenal hyperplasia (CAH) with a novel mutation of the CYP21A2 gene
- Central diabetes insipidus as a very late relapse limited to the pituitary stalk in Langerhans cell histiocytosis