Objective : The primary goal of this study was to define demographic factors that contribute and detract from patients’ perceived quality of life.
Methods : A two part online questionnaire was completed by 74 patients with DM1 between the ages 10 and 18 or their family members. The first part of the survey consisted of a demographics questionnaire. Parents and guardians assisted patients in filling out this portion. The second part consisted of a digitized version of the Quality of Life(QoL) for Youth Living with Diabetes Questionnaire completed by the patients themselves.
Results : A bivariate correlation identified patients’ Worries Score (r2 = 0.634) and Treatment Impact Score (r2 = 0.479) as the strongest correlates with respect to negative impact on QoL. Furthermore, a linear regression determined that Self-Health and Treatment Impact subscale scores described 16.5% of variation in HbA1c levels within the sample population. This was significant at the 0.05 alpha level (F(2,71) = 7.007, p=0.002). Income was the only demographic factor with a significant impact on QoL. Income was divided into low ($0-$49,999), middle ($50,000-$124,999), and upper ($200,000+). A one-way ANOVA determined that children from lower income households scored significantly higher on Symptoms Negative Impact than those from upper income households (F(3, 70)=3.342, p=0.024). While there were several individuals in the $0-24,999 income range,“prefer not to say” category, and in the upper income range, no participants reported themselves to be in the $25,000-$74,999 range.
Discussion : The most powerful factors of negative impact are diabetes-related worries and discomfort associated with treatment. Evidence indicates potential for Self Health Score and Treatment Impact Score to be used to predict HbA1c in youth with DM1. Given that Self-Health Scores and Treatment Impact Scores explain a relatively small portion of variation in HbA1c, the accuracy of self-perception of one’s own health is called into question. There is also indication that children living in lower income households may suffer more from symptoms of DM1 than those from higher income households.
Conclusion : The findings of this study underscore the necessity of robust social services for patients living near or below the poverty line. Income range trends elicit questions regarding which populations are most likely to seek treatment for DM1 and whether healthcare policy might play a role in shaping the patient population. Larger, comparative studies must be conducted before the the link between measures of QoL and DM1 is well understood.
Ciera Korte– Research Assistant, Center of Excellence in Diabetes and Endocrinology
Gnanagurudasan Prakasam– Medical Director, Sutter Medical Center, Granite Bay, California
Ciera Korte– Medical Director, Sutter Medical Center, Granite Bay, California
Center of Excellence in Diabetes and Endocrinology
Ciera Korte is a senior at Pacific Union College earning her Bachelor's of Science in psychology with an emphasis in pre-art therapy. After graduating she plans to work towards a doctorate in Clinical Psychology. Ciera currently works as a teaching assistant and student tutor for Research Design. She has presented research at Pacific Union College's Psychology and Social Work Colloquium and annual Psychology Symposium. Her current research includes investigation of the link between caffeine consumption and romantic arousal which will be presented at the Western Psychological Association's annual convention in April of 2019.
Sutter Medical Center
Granite Bay, California
Dr. Prakasam is Medical Director of Pediatric Endocrinology & Diabetes at Sutter Medical Center, Sacramento. He is currently a board member and immediate past president of the Leadership Council of the American Diabetes Association (ADA) in Northern California and also a board member in the Northern California Chapter of JDRF. He also served as a national committee member for ADA.
Furthermore, he is the founder and president of the Center of Excellence in Diabetes and Endocrinology in Sacramento, including 3 pediatric endocrinologists and 3 satellite offices in all, that takes care of more than 15000 patients with over 1200 patients with diabetes. The practice has one of the biggest pediatric insulin pump programs and growth disorders programs in the United States and is involved in several clinical trials in the field of diabetes and growth.
Additionally, he has organized several comprehensive pediatric endocrine CME programs in the US and is an active participant of CME programs around the world. He also serves an adviser, speake. lead principal investigator for multcenter studies and marketing consultant for several pharmaceutical companies, while running a unique patient support online program for children with diabetes, lifestyle issues and growth hormone deficiencies.
His areas of interest are social entrepreneurship, happiness and chronic disease management, e-health, medical social networking and family centered care. He has authored and co-authored multiple papers and abstracts and was a member of the working committee involved in the first guideline, published in November 2011, about transitioning children with diabetes from pediatrics to adults.
His recent interest is happiness as a tool at healthcare work place as well as management of diabetes.
He also accepts select invitations as motivational speaker on HAPPINESS, Social media and disease management and various other topics.