62-LB: Psychosocial and Socioeconomic Well-Being as Determinants of Quality of Life and Glycemic Control in Haitian Youth with Diabetes

Abstract

In low- and middle-income countries (LMIC), youth with diabetes suffer from poor glycemic control even if free insulin and diabetes care are provided. In Haiti, health-related quality of life (HRQL) among youth with diabetes is low. We validated depression, self-esteem and self-management scales (Table 1) in Haitian youth with diabetes and evaluated them as well as perceived health, subjective and objective social status as determinants of glycemic control and HRQL. In 85 participants (59% female, mean age 17.5±5 years, mean diabetes duration 3.7±3.5 years, mean HbA1c 11.3±2.6%, mean HRQL 61±16 out of 100, mean satisfaction score 64±20 out of 100) mild, moderate and moderately-severe depression rates were 38%, 21% and 7% respectively, self-esteem score was 61±12 on a scale of 0 to 100 and perceived self-management score was 45±17 on a scale of 0 to 100. No measure predicted glycemic control (p>0.05 for all). When adjusted for age, sex and diabetes duration, higher self-esteem (p=0.003), higher subjective SES (p=0.04) and lower depression score (p<0.05) remained significant determinants of HRQL. Higher objective SES (p=0.01) and lower depression score (p=0.04) remained determinants of satisfaction. Depression and objective SES emerge as intervention targets while subjective psychosocial health emerges as a resilience worth nurturing to improve HRQL and life satisfaction. Disclosure R. Vincent: None. Z. Kamal: None. B. Coriolan: None. K. Altenor: None. J.E. von Oettingen: None.