Predictors of the Diabetes-Specific Quality of Life in Adolescents With Type 1 Diabetes Mellitus: A Hospital-Based Cross-Sectional Study

TL;DR

This study finds that most teenagers with type 1 diabetes have a poor quality of life, and factors like age, father's job, and blood sugar control play a role.

Contribution

The study identifies specific predictors of diabetes-specific quality of life in Indian adolescents with type 1 diabetes.

Findings

Over half of the adolescents had impaired diabetes-specific quality of life.

Age, father's occupation, and glycemic control were independent predictors of quality of life.

Psychosocial support and self-management are essential for improving outcomes.

Abstract

Introduction

Adolescence is a crucial developmental stage marked by significant changes in social, psychological, and physical aspects of life. The demands of managing type 1 diabetes mellitus (T1DM) throughout life, such as administering insulin, monitoring blood sugar, controlling nutrition, and fear of both acute and long-term complications, exacerbate these developmental difficulties for teenagers. Their quality of life (QoL) can be significantly impacted by these factors; hence, evaluating QoL and its determinants is a crucial part of comprehensive diabetes management.

Methods

An analytical cross-sectional study was conducted at the Diabetic Clinic of Government Medical College, Thiruvananthapuram, a tertiary care center in Kerala, India, with 141 adolescents aged 10 to 18 years who attended the diabetic clinic from July 2023 to February 2024. All were on regular treatment for at least six months. Data collection utilized a structured questionnaire that included both sociodemographic and diabetes-related data. HbA1c was measured using high-performance liquid chromatography (HPLC). Based on the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2022 criteria, children were classified as having good (<7%) or poor (>7%) glycemic control. Diabetes-specific QoL (DSQoL) was measured by using the PedsQL 3.2 Diabetes Module.

Results

Among the 141 participants, 83 participants (58.9%) had a DSQoL score of less than 70, indicating that more than half of the adolescents with T1DM had impaired QoL. Of the adolescents with diabetes, only 41.1% showed optimal QoL. This result shows that adolescents have a significant burden of physical, psychological, and treatment-related difficulties due to diabetes, which emphasizes that medical management alone is not enough, and psychosocial interventions are clearly essential. Factors including age, occupation of father, duration of diabetes, dietary adherence, physical activity, and glycemic control were found to be associated with DSQoL. Binary logistic regression identified independent predictors: age (adjusted odds ratio (aOR) = 2.703; 95% confidence interval (CI): 1.186-6.156; p = 0.018), occupation of father (aOR = 2.383; 95% CI: 1.040-5.459; p = 0.040), and glycemic control (aOR = 0.433; 95% CI: 0.192-0.973; p = 0.043).

Conclusion

The findings highlight that DSQoL is compromised in the majority of adolescents with T1DM. This underscores the need for targeted psychosocial interventions, improved self-management support, and regular assessment of QoL as part of routine diabetes care.