Health-Related Quality of Life in Children with Type 1 Diabetes in Armenia

Abstract

Background: Type 1 diabetes mellitus (T1DM) is the life-threatening chronic disease if left without appropriate clinical care and self-management. Diabetes places a burden on family life and daily routine that can be reduced by a proper disease management program. Extensive research studies are conducted for the estimation of pediatric quality of life (PedsQL) in the medical and psychosocial care of diabetic children. Objectives: To evaluate the quality of life of children 8 - 12 y/o with T1DM, to compare PedsQL perceived by their parents, to understand influence of gender and other factors on PedsQL and disease management. Methods: Children with T1DM were identified and recruited from the pediatric endocrinology department registries. We used the validated adapted pediatric quality of life inventory 3.0 diabetes module of the child (ages 8 - 12) and parent reports. Obtained scales were compared between children and parents as well as between the two genders. Results: A total of 132 T1DM children and their primary caregivers participated in the study. The mean age of the children was 6.82 ± 2.17 years. Girls had higher (17.82 ± 1.59) body mass index (BMI) than boys (17.1 ± 1.95; OR = 0.72; P value 0.021). Mean levels of HbA1C were different in genders: 9 ± 1.78 for girls and 7.93 ± 1.0 for boys (P < 0.001). Diet habits of diabetic children with uneducated primary caregiver have not been changed (P value 0.0138) and these children more often experienced hypoglycemia (P < 0.001). Regular exercising had positive effect on level of HbA1C (7.8 ± 0.82 versus 8.93 ± 1.73) (P value 0.003). In a comparison of PedsQL scores between boys and girls, we have found significant differences in 17 items and in 15 items between child and parent. Conclusions: In 8 - 12 y/o group of T1DM children, girls seem to be more sensitive towards pain and difficulties associated with the disease, boys experienced more difficulties related to treatment compliance and parents’ involvement. Primary caregivers mostly underestimated the child’s PedsQL.