Quality of life, psychological adjustment and metabolic control in youths with type 1 diabetes: a study with self- and parent-report questionnaires

Nardi L, Zucchini S, D’Alberton F, Salardi S, Maltoni G, Bisacchi N,Elleri D, Cicognani A. Quality of life, psychological adjustment andmetabolic control in youths with type 1 diabetes: a study with self- andparent-report questionnaires.Pediatric Diabetes 2008: 9: 496–503.Objective: To evaluate self and parent reports on quality of life (QoL)and psychological adjustment of youths with type 1 diabetes, incomparison to a general paediatric population, and identify relationshipsbetween disease duration, metabolic control and psychologicalparameters.Research design and methods: Participants included 70 youths with type1 diabetes and their parents. They were compared with 70 non-diabeticsubjects. Data were analyzed in the whole group and in subgroups aged6–10, 11–13 and 14–18 yr. All cases performed pediatric QoL, ChildBehaviour Checklist, filled in by parents, and Youth Self-Report, filled inby youths. Data were compared with haemoglobin A1c (HbA1c) valuesand disease duration.Results: Self-reports showed a psychological adjustment of youths withtype 1 diabetes similar to that of controls. Parent reports showed thatparents of children with type 1 diabetes were more worried than those ofcontrols (p , 0.01). Adolescents showed a worse QoL and more frequentpsychological disturbances. In this group, for youth and parent reports,HbA1c levels correlated positively with psychological problems(p , 0.05) and negatively with QoL (p , 0.05). Only for parent reports,in the whole group and in subgroups aged 6–10 and 11–13 yr, diseaseduration correlated positively with psychological adjustment (p , 0.05).Conclusions: Before adolescence, youths with type 1 diabetes showedonly slight problems in psychological adjustment and QoL, with anassociation with disease duration reported by parents. In adolescence,both youths and their parents reported more emotional and behaviouralproblems, independent of disease duration. Better metabolic control andpsychological well-being seemed directly related.