May gender influence the quality of life in children and adolescents with type 1 diabetes?
Received 27 February 2019
Accepted for publication 14 August 2019
Published 20 September 2019 Volume 2019:13 Pages 1589—1597
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Karolina Dłużniak-Gołaska,1 Dorota Szostak-Węgierek,1 Mariusz Panczyk,2 Agnieszka Szypowska,3 Beata Sińska4
1Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland; 2Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland; 3Department of Pediatrics, The First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland; 4Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
Correspondence: Mariusz Panczyk
Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Zwirki i Wigury 61, Warsaw 02-091, Poland
Tel +48 22 572 0490
Fax +48 22 572 0491
Introduction: Appropriate health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes constitutes one of the most important factors that determine treatment effectiveness. There are numerous studies which tackle the issue of the relationship between HRQOL and various clinical and demographic factors, including gender. Therefore, the aim of the present study was to assess HRQOL and identify factors by which it may be affected, with particular emphasis on gender.
Material and methods: The study group included 197 girls and boys (13.9±2.33 years old) with a history of type 1 diabetes (>1 year) treated with the use of insulin pumps. PedsQL Diabetes Module 3.0 questionnaire was used in the assessment of HRQOL. Multivariate linear regression with gender as a covariate was used to investigate the relationship between total PedsQL score and selected variables associated with patient characteristics, insulin dosage and the control of glycemia. Moreover, the presence of gender differences was verified in terms of variables which significantly affected HRQOL.
Results: Significantly higher results were observed in boys as regards the total PedsQL score (70.8±11.91 vs 62.4±13.91; P<0.001) and individual subscales of the questionnaire (except “Worry”). Regression analysis demonstrated the presence of a significant negative relationship between HRQOL assessment and HbA1c concentrations, WHtR value and the frequency of hypoglycemic episodes. However, it was noted that better HRQOL was observed in boys than in girls, regardless of the quality of the metabolic control of diabetes, regular pattern of adipose tissue distribution and experiencing hyperglycemic episodes.
Conclusion: Female gender was an independent factor which adversely affected HRQOL. Other factors which negatively influenced HRQOL included poor metabolic control of diabetes, central distribution of adipose tissue and frequent episodes of hyperglycemia. It seems necessary to focus also on other factors that may potentially influence HRQOL of patients with type 1 diabetes.
Keywords: health-related quality of life, type 1 diabetes, gender differences
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