“Does cost of care influence the glycemic control, psychosocial illness and quality of care among adolescents with type 1 diabetes?: A hospital based cross section study in Mysuru, Karnataka

Abstract Context Type-1 Diabetes Mellitus, “a poor cousin of Type-2 Diabetes”, is the third commonest pediatric endocrine disease. On an average three new cases of T1DM/100,000 adolescents of 0–14 years are reported from India annually. Objective. To find out the relationship between cost of care and glycemic control, psychosocial illness and quality of life among adolescent with type -1 diabetes. Methods This cross sectional study was conducted in a tertiary care hospital in Mysore for a period of 6 months. Adolescents in the age group of 11–19 years with T1DM who were on treatment for at least one year were included. Direct and indirect cost incurred in diabetes management was collected from receipts. Glycemic control was assessed with fasting, postprandial blood sugar and HbA1C levels in last 3 investigations. Psycho social illness was assessed by DSM-5 (Diagnostic and Statistical Measure −5) criteria and quality of life was assessed using Health related quality of life questionnaire for Diabetics. Results Among 50 subjects of type-1 diabetes included in the study, median annual cost of care for was 25,758/- and of this 90.9% direct and 9.1% was indirect cost. There was a negative correlation between cost of care and glycemic control. The spending on diabetes care was lower among the subjects with psychosocial illnesses. The quality of life was poor among subjects who spend less on diabetes care. Conclusion There was a negative correlation between cost of care and glycemic control. Lower cost of care was associated with high burden of psychosocial illness and poor quality of life.