Self-rated health among American adolescents with type 1 diabetes in the T1D Exchange Clinic Registry

Abstract Background The goal of this study was to examine the self-rated health (SRH) of adolescents with type 1 diabetes (T1D). Methods A logistic regression analysis of baseline data from adolescents in the United States included in the T1D Exchange Clinic Registry in 2010–2012 was conducted. Participants were 13–18 years old at the time of enrollment in the registry and had been diagnosed with T1D at least one year before enrollment ( n  = 5799). Results Half (49.0%) of the participants were female, 46.3% were ages 16–18 years, 22.5% were non-white, 35.7% did not have private/military health insurance, and 78.8% had HbA1c levels > 7.5%, indicating poor T1D management, 20.7% reported having diabetes-related stress often or very often, and 46.4% used insulin injections or pens rather than a pump. In total, 10.3% ( n  = 600) of the participants rated their health as poor or fair and 59.3% ( n  = 3439) rated their health as very good or excellent. Participants with poor or fair SRH were more likely than those with very good or excellent SRH to be female (adjusted OR = 1.7(1.4, 2.1)), 16 to 18 years old (OR = 2.1(1.7, 2.5)), and non-white (OR = 2.7(2.2, 3.4)), to be without private or military insurance (OR = 2.4(2.1, 3.0)), to have HbA1c levels > 7.5% (OR = 3.3(2.4, 4.7)), to report having diabetes-related stress often or very often (OR = 6.1(5.1, 7.2)), and to use an injection or pen rather than a pump (OR = 2.1(1.6, 2.4)). Conclusions Because adolescents with T1D who report lower SRH are more likely to have uncontrolled blood glucose and frequent diabetes-related stress, use of pumps and stress-reduction strategies may improve SRH among adolescents with T1D.