ESPE Abstracts

Background: Costs and health related quality of life study for type 1 diabetes mellitus (CHRYSTAL) pediatric patients in Spain is an observational study conducted in 2014 on a representative sample of 275 patients aged 1–17 years with type 1 diabetes mellitus (T1DM) in Spain. The study collects diabetes specific health related quality of life (HRQoL) using the Diabetes Module of the Pediatric Quality of Life Inventory (PedsQL). This scale has been identified to be one of the best scales to describe HRQOL in pediatric population.

Objective and hypotheses: The objective was to describe the HRQoL for pediatric patients with T1DM in Spain and to compare results by HbA1c level.

Method: PedsQL is modular instrument composed of 28 items comprising five dimensions (diabetes, treatment I, treatment II, worry, and communication) graded on a scale from 0 to 4. Scores were converted from 0 to 100, where higher scores indicate higher HRQOL. The questionnaire was self-administrated on patients 8–17 and proxy completed by the caregiver for children two to seven. The overall and itemized mean scores by age ranges were calculated. Results by HbA1c level (HbA1c <7.5% vs HbA1c ≥7.5%) were analyzed by Mann–Whitney U test.

Results: Valid results were obtained for 268 patients. The proxy results indicated an overall HRQoL of 65.5 for patients with HbA1c ≥7.5% and 70.6 for those with HbA1c <7.5% in patients aged 2–7. For patients 8–17, the self-report indicated an overall HRQoL of 72.0 for patients with HbA1c ≥7.5% and 73.2 for those with HbA1c <7.5%. Results by age range were consistently lower among patients with HbA1c ≥7.5%, although differences by HbA1c level were not statistically significant. The ‘Worry’ dimension had the highest negative score on QOL across all age ranges.

Conclusion: CHRYSTAL is the first study to evaluate HRQoL in a representative sample of children and adolescents with T1DM in Spain. Interventions are needed to include HRQoL measures as part of the regular practice while managing diabetes for better assessment of diabetes care.

Funding: This work was supported by Eli Lilly and Company.