Quality of Life, Medication Adherence, and Glycemic Control in Type 1 Diabetes Mellitus Children with Basal Bolus Regimen During COVID-19 in Limited Resources Setting

Abstract

Background: Type 1 Diabetes Mellitus (T1DM) is a chronic disease that requires complicated therapies. The coronavirus disease 2019 (COVID-19) pandemic has caused lockdown restrictions, compromising access to medical care, including T1DM management. Poor medication adherence may affect the quality of life (QoL) and glycemic control. Objectives: This study analyzed the association among QoL, medication adherence, and glycemic control in T1DM patients during the COVID-19 pandemic. Methods: This study recruited T1DM patients aged 5 - 18 who regularly visited the pediatric endocrinology outpatient clinic. The PedsQL 3.2 and the diabetes management questionnaire (DMQ) were used to measure QoL and medication adherence. In addition, glycemic control was measured based on HbA1c levels. All data were analyzed using SPSS version 17, and correlations between variables were analyzed using Spearman or Pearson correlation tests. Results: Twenty-five children and adolescents with a mean age of 141.1 months (± 36.7) were included in this study. The mean HbA1c level was 10.7 mg/dL (± 2.4). Around 19 (76%) participants had already experienced diabetic ketoacidosis (DKA). There was no significant correlation between QoL and medication adherence or HbA1c level (P = 0.220, r = - 0.254; P = 0.753, and r = - 0.066, respectively). Conclusions: Our study’s QoL and medication adherence of T1DM children was relatively good even though the HbA1c was still high. However, numerous factors affect QoL and medication adherence in T1DM children other than HbA1c level.