Quality of Life of Adolescents with Type 1 Diabetes Mellitus from the Pediatric Endocrinology Unit of the Pediatric Hospital of Coimbra

Introduction: The treatment of type 1 diabetes mellitus (DM1) can be a source of stress in youth and can negatively impact their quality of life (QOL). Worse QOL relates to higher glycated hemoglobin (HbA1c). Lower HbA1c is associated with less worry and better perceived health, and better metabolic control is associated with better mental and physical health. Youth with DM1 are at increased risk for psychopathology. Children with DM1 and psychopathology have worse adherence and more treatment difficulties. The goal of this study was to evaluate the QOL of a sample of adolescents with DM1 followed at the Pediatric Endocrinology Unit of the Hospital Pediatrico de Coimbra (E-HP) and comparing it regarding different treatment types. Methods: Age, sex, treatment type and last HbA1c value were collected. Quality of Life Assessment Scale for Adolescents with Diabetes (DQOL) was applied. Results: Fifty four adolescents (36 boys + 18 girls), aged 14.72 +/- 2.03 years, 6 under multiple administrations of insulin analogues (MAAI), 13 under continuous subcutaneous insulin infusion (ISCI), 15 under MAAI + continuous glucose monitoring system (SMCG) and 20 under ISCI+SMCG. We found a statistically significant positive correlation between HbA1c and total DQOL (r=0.347, n=54, p=0.010) and between HbA1c and the DQOL "Satisfaction" subscale (r=0.314, n=54, p=0.021). We found statistically significant differences between the HbA1c of users of MAAI, ISCI, MAAI+SMCG and ISCI+SMCG (7.29 +/- 1.02 vs 7.58 +/- 1.57 vs 8.33 +/- 1. 28 vs 9.30 +/- 1.44, p=0.007), between the average score of the DQOL parameter "Concerns due to diabetes" of users with and without SMCG (12.40 +/- 3.97 vs 15, 47 +/- 5.47, p=0.021), between the average score of the DQOL parameter "Concerns" between sexes (15.44 +/- 3.71 vs 12.50 +/- 4.94, p=0.030) and a statistically significant positive correlation between total DQOL and the self-assessment item (r=0.556, n=54, p<0.001). Conclusion: DM1 can have a great impact on users' QOL and be a risk factor for psychopathology. Psychosocial changes in adolescence can lead to worse treatment adherence, metabolic control and QOL. It is important to identify the psychological factors involved in a healthy adjustment to the disease and ensure quality psychoeducation. An interdisciplinary, biopsychosocial intervention, centered on the individual and the family, is necessary to monitor these adolescents.