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J Pediatr. 2014 Jun;164(6):1376-83.e1. doi: 10.1016/j.jpeds.2014.01.027. Epub 2014 Feb 26.

Longitudinal associations between sex, diabetes self-care, and health-related quality of life among youth with type 1 or type 2 diabetes mellitus.

Author information

1
Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest Medical School, Winston-Salem, NC. Electronic address: naughton@wakehealth.edu.
2
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.
3
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
4
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
5
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
6
Barbara Davis Center, University of Colorado School of Medicine, Denver, CO.
7
Kaiser Permanente Center for Health Research Hawaii, Honolulu, HI.
8
Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
9
Seattle Children's Research Institute, Endocrinology, Seattle, WA.

Abstract

OBJECTIVE:

To examine the longitudinal associations between sex, diabetes self-care, and the health-related quality of life (HRQL) of children and adolescents with type 1 or type 2 diabetes.

STUDY DESIGN:

The sample included 910 participants with type 1 and 241 participants with type 2, ages 10-22 years at baseline, from the SEARCH for Diabetes in Youth Study, a longitudinal observational study. The primary outcome measure was the Pediatric Quality of Life Inventory. Repeated measures, mixed-model regression analysis was conducted with the use of data from baseline and at least one follow-up assessment, spanning approximately 4 years.

RESULTS:

HRQL was greater among those with type 1 versus type 2 diabetes. Among participants with type 1, greater (better) Pediatric Quality of Life Inventory total scores over time were related to greater parent education (P = .0007), lower glycated hemoglobin values (P < .0001), and greater physical activity during the past 7 days (P = .0001). There was a significant interaction between sex and age (P < .0001); girls' HRQL remained stable or decreased over time, whereas males' HRQL increased. For participants with type 2 diabetes, there was no significant interaction by age and sex, but lower total HRQL was related to being female (P = .011) and greater body mass index z-scores (P = .014).

CONCLUSIONS:

HRQL in this cohort varied by diabetes type. The interaction between sex and age for type 1 participants, coupled with poorer HRQL among female than male participants with type 2 diabetes, suggests the impacts of diabetes on HRQL differ by sex and should be considered in clinical management. Encouraging physical activity and weight control continue to be important in improving HRQL.

PMID:
24582483
PMCID:
PMC4500167
DOI:
10.1016/j.jpeds.2014.01.027
[Indexed for MEDLINE]
Free PMC Article

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