Glycemic control versus quality of life in a cohort of diabetic children from South Kerala

Abstract

Background: Assessment of HRQOL (Health related quality of life) in clinical practice is important to determine the course of the disease, early recognition of problems and the type of insulin therapy that would be adequate to maintain satisfactory metabolic control with less impact on HRQOL in every patient. Methods: A cross-sectional analytical study was conducted in the tertiary care hospital in Kerala. All children’s who aged 4-18 years with type 1 diabetes mellitus (DM) attending pediatric OPD in a tertiary care hospital in Kerala were included. The study period was 18 months. PedsQL diabetes module 3.0 (pediatric quality of life inventory 3.0 diabetes module) and PedsQL generic core module 4 (pediatric quality of life inventory 4.0 generic core scale) were used as tools. Results: The study population included 30 children with type 1 DM. The average duration of diabetes was 5.60±2.990 years. Based on HbA1c level, 16 [53.3%] children had well controlled diabetes and 14 [46.7%] had poorly controlled diabetes. Eighteen [80%] patients had complications in the form diabetic ketoacidosis or hypoglycemia in the past 1 year. Diabetes specific quality of life mean scores were [child report and parent proxy report] 88.4 and 85.9 for poorly controlled diabetes group and 94.4 and 93.0 for well controlled group respectively which showed a significant difference (p value 0.004). Children with better glycemic control also showed better generic score (p value-0.004). Conclusions: Metabolic control, measured by HbA1c value, was significantly associated with QoL in patients with diabetes. Good glycemic control is associated with better quality of life and less diabetes related symptoms.