Basma AbdelMoez Ali, AbdelHakim AbdelMohsen Abdelhakm, Mohamed Ayman Abdelhameed and Noha Kamel Tawfik
Introduction: Children with T1D experience behavioral difficulties and lower social competency compared with healthy children. Quality of life is considered to be a significant indicator of disease prognosis.
Aim: To evaluate the health related quality of life of children with T1D, and how much it could be affected by their mood and family attitudes and to study the relationship between these variables and the metabolic control of the diabetic children.
Methods: 72 children with T1D were included and subjected to; history taking, clinical examination, application of Peds QL (Diabetes Module, Version 3), Childhood Depression inventory Scale (CDI),Parent Stress Index(PSI) questionnaire and HbA1c%. Another 72 children apparently healthy, non-diabetic, age and sex matched and siblings of the diabetic patients were included as a control group. They were subjected to Childhood Depression inventory Scale (CDI), Parent Stress Index (PSI) questionnaire.
Results: Diabetic patients had significant higher CDI Score and total PSI score than the control group. There were significant positive fair correlations between the age, weight and BMI of diabetic children with the child PedsQL, the parent PedsQL and CDI total scores. Concerning glycemic control, there were significant positive fair correlations between CDI total score with frequency of DKA attacks and HbA1c%. Using the PSI domains, poorly controlled diabetic patients had significant higher parental distress, parent/child dysfunctional interactions and higher PSI total score compared to good controlled patients. Using CDI domains, poorly controlled diabetic patients had significantly more negative self- esteem than good controlled patients. There was a significant positive moderate relationship between CDI total score and PSI score. Finally, there were significant negative weak correlations between PSI score and PedsQL (child and parental) i.e. the higher the parental stress, the lower the quality of life of the diabetic child (reported by both child and parent).
Conclusion: diabetic children, especially the poorly controlled ones, are significantly suffering from symptoms of depression which causing stress for their parents and this has significant impact on their quality of life and glycemic control.