ESPE Abstracts (2014) 82 LBP-D--3-1008

Long-Term Impact of Childhood-Onset Type 1 Diabetes: Social Insertion, Quality of Life, Sexuality

Hélène Mellerioa,b, Sophie Guilmin-Crépona,b, Paul Jacquinc, Corinne Albertia,b & Claire Levy-Marchald

aUniv Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, Paris, France; bInserm, ECEVE U1123 et CIC-EC 1426, Paris, France; cAssistance Publique-Hôpitaux de Paris, Hôpital R. Debré, Médecine de l’adolescent, Paris, France; dInserm, CIC-EC, CIC 1426, Paris, France

Background: Little is known about the long-term social outcome of diabetic children.

Objective and hypotheses: This study aimed to describe social and professional life, quality of life (QOL) and sexuality at adult age of children and adolescents with type 1 diabetes (T1D).

Method: Participants (n=388, age=28.5±3.1 years; duration of diabetes=17.0±2.7 years, recruited from a French national register) completed a questionnaire (198 items). Data were compared to French general population (FGP) using indirect standardized ratios (SIR) or Z-scores matched for age, gender and period+/− educational level, familial life. Linear regression was used to investigate correlates of Physical (PCS) and Mental (MCS) SF36 Composite Scores.

Results: Educational level was similar to FGP (68.6%≥high school degree, SIR=1.06 (CI 95%: 0.93;1.20)), as well as familial life pattern. Unemployment was increased in women (15.3%, SIR=1.50(1.00; 2.10)) but not in men (8.6%, SIR=0.96(0.51; 1.57)). Social discrimination was more common (SIR=5.64(4.64; 6.62)). Only 25.7% of participants were homeowner (SIR=0.72(0.57; 0.89)). Frequency of daily alcohol consumption was increased (SIR: men=3.34(2.38; 4.54); women=6.53(4.57; 12.99)); 7.2% (12/166) of men consumed more than recommended (2 glasses/day), 5.0% (11/220) of women (1 glass/day). Overall, 7.1% were very dissatisfied with sexual life (SIR=1.90(1.18; 2.75)). Prevalence of sexual problems was higher in women (SIR: dysorgasmia=1.91(1.21; 2.88); decrease/loss of desire=2.11(1.35; 3.08)), but similar in men. PCS and MCS were moderately (mean=52.0±7.5; mean Z-score=−0.2(CI 95%:−0.3; −0.1)) and substantially (42.1±12.4; −0.7(−0.8; −0.6)) decreased respectively. Fatigue and abandoning sport were predictive of decreased QOL. Participants with complication(s) had preserved social outcomes but altered QOL. Young adults with T1D have a satisfying social well-being but lower MCS, frequent dissatisfaction with sexuality and uncommon alcohol consumption suggest the high impact of disease on morale, especially in women. Improve the screening of sexual problems and alcohol consumption, as well as optimize the patients’ psychological support to cope with the T1D burden must be high priorities for health caregivers.

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