Evaluation of Quality of Life of Children and Adolescents with Type 1 Diabetes Mellitus and Continuous Subcutaneous Insulin Infusion

Introduction: Type 1 diabetes mellitus (DM1) usually appears in childhood or adolescence and is characterized by total dependence of exogenous insulin administration. The aim of this study was to evaluate the quality of life of children and adolescents with DM1 and continuous subcutaneous insulin infusion in comparison with those on multiple daily insulin injections and to identify predictive factors of quality of life. Methods: Cross-sectional analytical study. The quality of life of 48 children and adolescents with DM1 aged 10-18 years (15 with continuous subcutaneous insulin infusion and 33 on multiple daily insulin injections) was evaluated using the Diabetes Quality of Life Scale (DQOL). Parametric and non-parametric tests were used to compare DQOL scores between the two groups, and to assess differences in metabolic control, health-related self-evaluation and satisfaction with current treatment between groups. Multiple linear regression was used to find predictive factors of quality of life. Results: Children/adolescents treated with continuous subcutaneous insulin infusion reported better quality of life, a more positive health-related self-evaluation and more satisfaction with current treatment when compared with those on multiple daily insulin injections. No statistically significant difference was found in metabolic control between the two groups. The type of insulin treatment and current age were identified as statistically significant independent predictors of the DQOL global score. Conclusions: Quality of life assessment is a crucial resource to be considered in the follow-up of children and adolescents with multiple daily insulin injections as it allows a more complete and individualized approach in the care of this young population. In this study, continuous subcutaneous insulin infusion was found to be one of the main determinant factors of quality of life.