ESPE Abstracts

Background: HRQoL has been acknowledged as an essential health outcome measure. Studies have shown that enhancing the HRQoL and well-being of children with diabetes is as important as metabolic control in preventing secondary morbidity. Objectives: to evaluate HRQoL of children and adolescents with T1D managed at our institute and investigate factors (patient and disease-related) associated with HQoL scores.

Methods: a cross-sectional study on patients (2-18 years) with T1D managed at a Tertiary Pediatric Diabetes Center in Sep-Nov 2022. Subjects were selected by their availability during routine visits and interviewed using Arabic translated version of PedsQL; Inventory 3.0 Diabetes Module which consists of a 28-item multidimensional instrument evaluating diabetes symptoms, treatment barriers and adherence, worry, and communication. Children aged 5–18 years provided self-reports, and parents of children aged 2–18 years provided parent proxy reports. Higher scores indicated better QoL.

Results: A total of 105 children with T1D and their parents participated. The median age of patients was 11.5 years (8.1- 17.7); 47.6% were males with an average duration of diabetes of 3.7 years and a median HbA1C of 8.4% (7.5 - 9.7). Of all, 73.3% were using MDI Insulin while 26.7% were on insulin pump therapy. Parents gave lower HRQoL scores than their children; highest differences were in treatment barriers, worry, and communication domains (p < 0.0001 and P=0.001 and P=0.03; respectively). Overall, there was excellent agreement in responses (Pearson coefficient= 0.92; P=0.0001) between children and parents; highest in Treatment Adherence (81%), Diabetes Symptoms, and communication (80% in both). There was a strong linear relationship between HRQoL and HbA1C, with better scores reported in those with HbA1C of 7% or lower (P=0.004). Univariate analysis revealed a significant association between better HRQoL and duration of diabetes (P=0.002), method of glucose monitoring (P=0.02), insulin regimen (P=0.002) while both gender and age didn’t impact the HRQoL score. Stepwise multiple regression analyses confirmed that HQoL was better in those with lower HbA1C and diabetes durations beyond 5 years (p 0.01& p 0.002; respectively). Conclusions: In our cohort, optimal glycemic control and diabetes duration beyond 5 years were significantly associated with higher HRQoL. The findings have implications for designing effective therapeutic interventions aimed at improving HRQoL of children with T1D. We recommend that assessment of QoL in children with a chronic disease should be a routine practice to facilitate communication, identify potential problems and implement an early intervention.