Longitudinal associations between sex, diabetes self-care, and health-related quality of life among youth with type 1 or type 2 diabetes mellitus
Michelle J Naughton, Joyce P Yi-Frazier, Timothy M Morgan, Michael Seid, Jean M Lawrence, Georgeanna J Klingensmith, Beth Waitzfelder, Debra A Standiford, Beth Loots, SEARCH for Diabetes in Youth Study Group, Jean M Lawrence, Kristi Reynolds, Mary Helen Black, Harpreet S Takhar, Kim Holmquist, Jin-Wen Hsu, David J Pettitt, Dana Dabelea, Richard F Hamman, Lisa Testaverde, Georgeanna J Klingensmith, Marian J Rewers, David Maahs, Paul Wadwa, Stephen Daniels, Kristen Nadeau, Clifford A Bloch, Carmelita Sorrelman, Jeffrey Powell, Kathy Love-Osborne, Carol Greenlee, Beatriz L Rodriguez, Wilfred Fujimoto, J David Curb, Fiona Kennedy, Greg Uramoto, Sorrell Waxman, Richard Chung, Beth Waitzfelder, Teresa Hillier, Lawrence M Dolan, Michael Seid, Elaine Urbina, Amy Shah, Debra A Standiford, Elizabeth J Mayer-Davis, Joan Thomas, Anwar Merchant, Angela D Liese, Robert R Moran, Gladys Gaillard-McBride, Malaka Jackson, Lisa Knight, Deborah Bowlby, James Amrhein, Bryce Nelson, Pam Clark, Mark Parker, Catherine Pihoker, Maryam Afkarian, Irl Hirsch, Lenna L Liu, John Neff, Joyce Yi-Frazier, Beth Loots, Patricia D'Alessandro, Jessica Fosse, Sue Kearns, Mary Klingsheim, Katherine Cochrane, Michael Pascual, Connor Mitrovich, Carla Greenbaum, Giuseppina Imperatore, Desmond E Williams, Henry S Kahn, Bernice Moore, Gregg W Edward, Sharon H Saydah, Barbara Linder, Santica M Marcovina, Vinod P Gaur, Jessica Harting, Ronny Bell, Ralph D'Agostino Jr, Jasmin Divers, Wei Lang, Timothy Morgan, Michelle Naughton, Leora Henkin, Gena Hargis, Maureen T Goldstein, Jeanette Andrews, Nora Fitzgerald, Scott Isom, Jennifer Talton, Michelle J Naughton, Joyce P Yi-Frazier, Timothy M Morgan, Michael Seid, Jean M Lawrence, Georgeanna J Klingensmith, Beth Waitzfelder, Debra A Standiford, Beth Loots, SEARCH for Diabetes in Youth Study Group, Jean M Lawrence, Kristi Reynolds, Mary Helen Black, Harpreet S Takhar, Kim Holmquist, Jin-Wen Hsu, David J Pettitt, Dana Dabelea, Richard F Hamman, Lisa Testaverde, Georgeanna J Klingensmith, Marian J Rewers, David Maahs, Paul Wadwa, Stephen Daniels, Kristen Nadeau, Clifford A Bloch, Carmelita Sorrelman, Jeffrey Powell, Kathy Love-Osborne, Carol Greenlee, Beatriz L Rodriguez, Wilfred Fujimoto, J David Curb, Fiona Kennedy, Greg Uramoto, Sorrell Waxman, Richard Chung, Beth Waitzfelder, Teresa Hillier, Lawrence M Dolan, Michael Seid, Elaine Urbina, Amy Shah, Debra A Standiford, Elizabeth J Mayer-Davis, Joan Thomas, Anwar Merchant, Angela D Liese, Robert R Moran, Gladys Gaillard-McBride, Malaka Jackson, Lisa Knight, Deborah Bowlby, James Amrhein, Bryce Nelson, Pam Clark, Mark Parker, Catherine Pihoker, Maryam Afkarian, Irl Hirsch, Lenna L Liu, John Neff, Joyce Yi-Frazier, Beth Loots, Patricia D'Alessandro, Jessica Fosse, Sue Kearns, Mary Klingsheim, Katherine Cochrane, Michael Pascual, Connor Mitrovich, Carla Greenbaum, Giuseppina Imperatore, Desmond E Williams, Henry S Kahn, Bernice Moore, Gregg W Edward, Sharon H Saydah, Barbara Linder, Santica M Marcovina, Vinod P Gaur, Jessica Harting, Ronny Bell, Ralph D'Agostino Jr, Jasmin Divers, Wei Lang, Timothy Morgan, Michelle Naughton, Leora Henkin, Gena Hargis, Maureen T Goldstein, Jeanette Andrews, Nora Fitzgerald, Scott Isom, Jennifer Talton
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.
Conflict of interest statement
The other authors declare no conflicts of interest.
Copyright © 2014 Elsevier Inc. All rights reserved.
Source: PubMed