Health-Related Quality of Life Among German Youths With Early-Onset and Long-Duration Type 1 Diabetes
- Anna Stahl, PHD1⇓,
- Klaus Straßburger, PHD1,
- Karin Lange, PHD2,
- Christina Bächle, MSC1,
- Reinhard W. Holl, MD3,
- Guido Giani, PHD1 and
- Joachim Rosenbauer, MD1
- 1Institute of Biometry and Epidemiology, German Diabetes Center (DDZ), Leibniz Center at the Heinrich Heine University, Düsseldorf, Germany
- 2Medical Psychology Unit, Hannover Medical School, Hannover, Germany
- 3Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
- Corresponding author: Anna Stahl, .
OBJECTIVE To evaluate self- and parent-reports of general health status and health-related quality of life (QoL) in children and adolescents with early-onset and long-lasting type 1 diabetes compared with the general population in Germany.
RESEARCH DESIGN AND METHODS A total of 629 subjects aged 11 to 17 years, with a type 1 diabetes onset occurring from age 0 to 4 years during the years 1993–1999, and their parents, completed questionnaires, including the generic KINDL-R Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, revised version, to assess QoL. The comparison group (n = 6,813) was a representative sample from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. Regression analyses were conducted using sociodemographic and health-related covariates.
RESULTS Intensified insulin therapy was used to treat 93% of children and adolescents with type 1 diabetes. They reported “excellent” general health as often as peers (adjusted OR 0.83 [95% CI 0.66–1.04] for an “excellent” rating), but the parent-rated general health was worse than that in the general population (OR 0.60 [0.48–0.74]). The patients reported increased self-esteem (adjusted difference β = 4.39 [SE 0.82]; P < 0.001) and well-being at school (β = 3.41 [0.77]; P < 0.001) but lower well-being within their families (β = –2.42 [0.80]; P = 0.002). The self- and parent-reported total QoL did not differ between the patient group and the general population. The adjusted difference (SE) between the two samples in total QoL was β = 0.89 (0.52; P = 0.087) in the self-reports and β = –0.98 (0.53; P = 0.066) in the parent-reports.
CONCLUSIONS Compared with the general population, the QoL and general health status were not impaired among those aged 11–17 years with early-onset type 1 diabetes, despite the challenges of modern therapy.
- Received December 15, 2011.
- Accepted March 29, 2012.
- © 2012 by the American Diabetes Association.
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