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Demographic and Clinical Correlates of Diabetes-Related Quality of Life among Youth with Type 1 Diabetes - 24/07/12

Doi : 10.1016/j.jpeds.2012.01.016 
Jean M. Lawrence, ScD, MPH, MSSA 1, , Joyce P. Yi-Frazier, PhD 2, Mary Helen Black, PhD 1, Andrea Anderson, MS 3, Korey Hood, PhD 4, Giuseppina Imperatore, MD, PhD 5, Georgeanna J. Klingensmith, MD 6, Michelle Naughton, PhD 3, Elizabeth J. Mayer-Davis, PhD 7, Michael Seid, PhD 8

SEARCH for Diabetes in Youth Study Group

  A list of members of the SEARCH for Diabetes in Youth Study is available at www.jpeds.com (Appendix 1).

1 Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 
2 Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 
3 Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 
4 Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 
5 Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA 
6 Barbara Davis Center, University of Colorado, Denver, CO 
7 Departments of Nutrition and Medicine, Gillings School of Global Public Health and School of Medicine, University of North Carolina, Chapel Hill, NC 
8 Division of Pulmonary Medicine and James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 

Reprint requests: Jean M. Lawrence, ScD, MPH, MSSA, Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S Los Robles, 4th Floor, Pasadena CA 91101.

Abstract

Objectives

To evaluate the reliability and cluster structure of the Pediatric Quality of Life Inventory Type 1 Diabetes Module 3.0 (PedsQL-T1DM) and associated subscales and to explore the associations between PedsQL-T1DM total score and demographic and clinical characteristics and clinical indicators among a large racially/ethnically diverse cohort of youth with type 1 diabetes.

Study design

Principal components analysis was conducted on responses from the PedsQL-T1DM child self-report forms completed by SEARCH for Diabetes in Youth study participants aged ≥5 years. Multivariate linear regression models were fit to examine the associations among PedsQL-T1DM total score, demographic and clinical characteristics, and clinical indicators.

Results

The sample comprised 2602 youth with a mean age of 13.6 ± 4.1 years and a mean T1DM duration of 62.1 ± 47.0 months. Principal components analysis did not support the 5 existing PedsQL-T1DM subscales. In multivariate analyses, the PedsQL-T1DM total score was negatively and significantly associated with younger age (5-7 years), female sex, receiving insulin by injection (vs pump), having parents without a college degree, Medicaid/Medicare insurance, and having a comorbid medical condition. Youth with poor glycemic control based on their age-specific hemoglobin A1c target values and those with depressive symptoms had significantly lower PedsQL-T1DM scores than their counterparts with good control and no or limited depressive symptoms.

Conclusion

This study has identified sociodemographic and clinical characteristics of youth with T1DM more likely to experience poor diabetes-specific quality of life. The association of lower PedsQL-T1DM scores with depressive symptoms and poor glycemic control is especially concerning and may be the focus of future interventions and studies.

Le texte complet de cet article est disponible en PDF.

Mots-clés : BMI, CES-D, DKA, ED, HbA1c, HRQOL, MCID, PCA, PedsQL-T1DM, T1DM


Plan


 Funding information is available at www.jpeds.com (Appendix 2). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors declare no conflicts of interest.


© 2012  Mosby, Inc. Tous droits réservés.
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Vol 161 - N° 2

P. 201 - août 2012 Retour au numéro
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