Metabolic control and quality-of-life self-assessment in adolescents with IDDM

OBJECTIVE - To examine the relation between metabolic control and self-assessed quality of life in adolescents with IDDM. RESEARCH DESIGN AND METHODS - The Diabetes Quality of Life (DQOL) questionnaire for youths was given to 69 subjects with IDDM aged 10-20 years at the time of their outpatient visit. Subjects with IDDM of <1 year's duration or with documented psychotic disorder or mental retardation were excluded. Metabolic control was assessed by the mean HbA(1c) during the preceding year (long-term), by a single HbA(1c) at the time of the visit (short-term), and by the number of acute events related to IDDM in the preceding year. RESULTS - The DQOL score correlated with mean HbA(1c) (beta = 6.13, R-2 = 0.22, P = 0.0122) and single HbA(1c) (beta = 3.94, R-2 = 0.18, P = 0.05). Self-health assessment was the best predictor of DQOL score (beta = -44.42, R-2 = 0.45, P < 0.0001). The Worries subscale score on DQOL correlated with the occurrence of acute events (beta = 6.97, R-2 = 0.2, P = 0.006), but did not corre late with either HbA(1c) level. Correlations of mean HbA(1c) with the predictors were stronger than the correlations of single HbA(1c) with the same predictors. CONCLUSIONS - Metabolic control and quality of life are two important outcomes of IDDM care. In our study adolescents in better metabolic control report better quality of life. Both components need to be addressed in developing successful diabetes treatment strategies for adolescents with IDDM.