Influence of socioeconomic factors on glycemic control, therapeutic adherence and quality of life in children and adolescents with type 1 diabetes

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM Endocrinologia Diabetes Y Nutricion Pub Date : 2024-06-01 DOI:10.1016/j.endien.2024.04.003

Carmen Yoldi-Vergara , Ignacio Conget-Donlo , Roque Cardona-Hernandez , Marta Ramon-Krauel

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Abstract

Objective

To stablish the relationship between socioeconomic status of a cohort of children and adolescents with type 1 diabetes (T1D) with glycemic control, therapeutic adherence and diabetes quality of life (DQoL).

Patients y methods

A cross-sectional, observational study with consecutive inclusion was carried out. Participants aged 8–18 years with T1D duration >1 year. Data on family structure, family income, parents’ educational level and parental role on primary diabetes care supervision were registered. Adherence (DMQ-Sp) and DQoL (PedsQl) were analyzed. Linear and logistic regression models adjusted for demographics, family structure and parental role on primary diabetes care responsibility were applied.

Results

A total of 323 patients (T1D duration 5,3 ± 3,3 years; HbA1c 7,7 ± 1,0%; age 13,3 ± 2,8 years; 49,8% females) were included. Patients living in a nuclear family and those whose main diabetes care supervision was shared by both parents showed lower HbA1c [adjusted for demographics and family structure (7,06; CI 95% 6,52–7,59); adjusted for demographics and role on primary diabetes care supervision (7,43; CI 95% 6,57–8,28)]. DMQ-Sp score (adjusted for demographics and role on main supervision) was higher in patients whose parents shared the diabetes care supervision (84,56; CI 95% 73,93–95,19). Parents sharing diabetes care supervision showed a significantly higher PedsQl score (both 74,63 ± 12,70 vs mother 68,53 ± 14,59; p = 0,001).

Conclusions

Children and adolescents with T1D had lower HbA1c, better therapeutic adherence and better DQoL when lived in a nuclear family, with higher socioeconomic status and the responsibility for supervising diabetes care was shared by both parents.

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社会经济因素对 1 型糖尿病儿童和青少年血糖控制、治疗依从性和生活质量的影响。

目的确定 1 型糖尿病（T1D）儿童和青少年群体的社会经济地位与血糖控制、治疗依从性和糖尿病生活质量（DQoL）之间的关系：进行了一项连续纳入的横断面观察研究。参与者年龄为 8-18 岁，T1D 病程大于 1 年。登记了有关家庭结构、家庭收入、父母受教育程度和父母在初级糖尿病护理监督中的作用的数据。对依从性（DMQ-Sp）和 DQoL（PedsQl）进行了分析。采用线性和逻辑回归模型对人口统计学、家庭结构和父母在初级糖尿病护理责任中的角色进行了调整：共纳入 323 名患者（T1D 病程 5.3 ± 3.3 年；HbA1c 7.7 ± 1.0%；年龄 13.3 ± 2.8 岁；49.8% 为女性）。生活在核心家庭和主要糖尿病护理监护由父母双方共同承担的患者的 HbA1c 较低[根据人口统计学和家庭结构进行调整后为 7.06；CI 95% 为 6.52-7.59；根据人口统计学和主要糖尿病护理监护角色进行调整后为 7.43；CI 95% 为 6.57-8.28]。父母共同承担糖尿病护理监督工作的患者的 DMQ-Sp 得分更高（根据人口统计学和主要监督角色进行调整后）（84,56；CI 95% 73,93-95,19）。共享糖尿病护理监督的父母的 PedsQl 得分明显更高（父母均为 74,63 ± 12,70 vs 母亲为 68,53 ± 14,59; p = 0,001）：结论：T1D 儿童和青少年如果生活在社会经济地位较高的核心家庭中，且父母双方共同承担糖尿病护理监督责任，则 HbA1c 更低、治疗依从性更好、DQoL 更高。

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来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.