Glycemic control may improve QoL in youths with type 1 diabetes
medwireNews: Lower levels of glycated hemoglobin (HbA1c) are associated with better diabetes-specific health-related quality of life (D-HRQoL) among young people with type 1 diabetes, researchers report.
In the TEENs study, Barbara Anderson (Baylor College of Medicine, Houston, Texas, USA) and colleagues analyzed data from 5887 patients aged between 8 and 25 years from 20 countries across five continents. They found a significant association between HbA1c levels and PedsQL Diabetes Module 3.0 D-HRQoL scores after adjustment for age group and region.
Participants achieving target HbA1c levels below 7.5% scored a mean 71.5 points, whereas those with HbA1c levels between 7.5 and 9.0% scored 68.4 points, a significant difference.
And participants with the highest levels of HbA1c (>9%) had the lowest D-HRQoL scores, at an average of 64.8 points, “underscoring the strong association between better D-HRQoL and optimal glycemic control,” report the researchers in Diabetes Care.
However, only 31.9% of 1715 participants aged 8–12 years and 29.1% of 2846 aged 13–18 years achieved target HbA1c levels below 7.5%, while 18.4% of 1326 young adults aged between 19 and 25 years achieved target levels of less than 7.0%.
The team also found that female patients across all age groups reported significantly lower D-HRQoL scores than males (average 66.2 vs 70.2 points), highlighting “an important area of marked vulnerability for adolescent and young adult females with [type 1 diabetes] that requires increased research and improved clinical interventions.”
Furthermore, the researchers identified three diabetes management behaviors that were significantly associated with QoL. Patients who used advanced methods to measure food intake – such as carbohydrate counting and carbohydrate exchanges – had significantly better D-HRQoL scores than those who avoided simple sugars. More frequent daily blood glucose monitoring and exercising for at least 30 minutes on 3–7 compared with 0–2 days per week were also associated with improved D-HRQoL.
These findings point to “the interconnectedness of diabetes burden, self-management behaviors, and biological outcomes in this global sample of youth with [type 1 diabetes],” say Anderson and colleagues, noting that the relationships “highlight potential points for intervention.”
And they add that “by reducing diabetes burden, youth may check blood glucose levels more frequently, which has been documented to correlate with better glycemic control.”
The team notes that because the TEENs study had a cross-sectional design, “it will be important to test the hypotheses generated in this study in a longitudinal study of global youth with [type 1 diabetes].”
Nevertheless, they conclude that the findings “are important with respect to calling for prioritization of the immediate development of effective clinical interventions to optimize glycemic control and D-HRQOL of youth with [type 1 diabetes], especially for adolescent and young adult females.”
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