Abstract
Objective: The aim of this study was to examine a possible association of HbA1c, quality of life (QoL), fitness, and electrophysiological parameters in children with type 1 diabetes mellitus (T1DM). Methods: The study population (n = 34) consisted of patients with T1DM (n = 17) and an age-, sex-, and BMI-matched healthy control group (n = 17). HbA1c was obtained from patients with T1DM at time of diagnosis (T0), at 6 months (T6), at 12 months (T12), and at time of study inclusion (Tstudy). QoL was determined with a standardized questionnaire (KINDL-R). All children completed a 6-min walk test (6MWT) to evaluate their fitness level. Electrodiagnostic studies established upper and lower limb motor and sensory nerve conduction velocities (NCV). Results: Higher HbA1c (Tstudy) was associated with lower QoL showing in the subscales self-esteem, friends, and school. Higher HbA1c at (T6) and (T12) was associated with lower QoL in the subscale self-esteem. Based on various subscales, perceived problem areas differed significantly between children and their parents. No differences in fitness level and NCV were found between patients and controls except for a significantly slower median motor NCV in patients. HbA1c was not associated with NCVs at this early stage of disease. Conclusions: Good metabolic control reflected by adequate HbA1c values seems to be important for a good QoL in children with T1DM. Early HbA1c might be associated with QoL during follow-up.
Highlights
One important goal of diabetes management in children and adolescents is to achieve psychological well-being and a high level of quality of life (QoL) despite chronic disease burden [1]
Healthy children matched for age, sex, and body mass index (BMI) seen as outpatients for routine were selected as the control group
The most important finding of the present study is that HbA1c obtained during the first year after diagnosis of disease is inversely correlated to certain subscales of QoL of patients with type 1 diabetes mellitus (T1DM) at time of study inclusion (Tstudy), i.e., some 5 years after disease onset
Summary
One important goal of diabetes management in children and adolescents is to achieve psychological well-being and a high level of quality of life (QoL) despite chronic disease burden [1]. The association of metabolic control and QoL in patients with type 1 diabetes mellitus (T1DM) has been already shown in several studies [2,3]. Hoey et al found that good metabolic control—indicated by lower HbA1c values—is associated with a better QoL in adolescents with T1DM [3]. Girls showed a poorer overall QoL than boys [3]. In the assessment of QoL, it seems important to separate ratings of children and their parents [4]. Ratings of adolescent QoL and burden perceived by parents were different [3]
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