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Impact of quality of life (QoL) on glycemic control (HbA1c) among adolescents and emerging adults with long‐duration type 1 diabetes: A prospective cohort‐study
Author(s) -
StahlPehe Anna,
Landwehr Sandra,
Lange Karin S.,
Bächle Christina,
Castillo Katty,
Yossa Rhuphine,
Lüdtke Jana,
Holl Reinhard W.,
Rosenbauer Joachim
Publication year - 2017
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12487
Subject(s) - medicine , glycemic , quality of life (healthcare) , diabetes mellitus , cohort , prospective cohort study , cohort study , insulin , endocrinology , nursing
Objective To evaluate the impact of self‐reported chronic‐generic and condition‐specific quality of life (QoL) on glycemic control among adolescents and emerging adults with long‐duration type 1 diabetes (T1D) in a longitudinal design. Methods The database used was a nationwide cohort study of patients with ≥10 years T1D duration at baseline in Germany. The baseline questionnaire survey was conducted in 2009‐2010, the follow‐up survey in 2012‐2013; additional clinical data of routine care procedures were linked. QoL was assessed by the DISABKIDS chronic generic module (DCGM‐12) and diabetes module (DM) with treatment and impact scales. Regression analyses were conducted for the outcome hemoglobin A1c (HbA1c) at follow up with baseline DISABKIDS scores as predictors and sociodemographic and health‐related covariates. Results At baseline, the included 560 patients had a mean age of 15.9 (SD 2.3) years, a diabetes duration of 13.0 (2.0) years, and an HbA1c of 67 (14.2) mmol/mol. Mean follow‐up time was 3.0 (0.6) years. Univariate analyses indicated associations between baseline QoL scores and HbA1c at follow‐up (β[DCGM‐12] = −0.174 (SE 0.038), β[DM treatment] = −0.100 (0.022), β[DM impact] = −0.177 (0.030), p < .001). The associations remained significant after adjustment for sociodemographic and illness‐related factors, but dissolved (p > .60) when additionally adjusting for baseline HbA1c. In patients with poor baseline HbA1c (>75 mmol/mol), significant associations were observed between DCGM‐12 and DM impact scores and follow‐up HbA1c (β[DCGM‐12] = −0.144 (0.062), p = .021; β[DM impact] = −0.139 (0.048), p = .004). Conclusions QoL was inversely associated with HbA1c after 3 years in the course of T1D only in patients poorly controlled at baseline.