Parent-Reported Diabetic-Specific Health Related Quality of Life in Children Treated with Multiple Daily Injection, Continuous Subcutaneous Insulin Infusion and Flexible Multiple Daily Injection: A Comparative Study

Aims: This study aims to identify differences in diabetes specific health related quality of life (HRQoL) in children and adolescents with type 1 diabetes mellitus (T1D) treated with three distinct types of intensive insulin therapymultiple daily injection (MDI), continuous subcutaneous insulin infusion (CSII) and flexible multiple daily injection (fMDI).

Materials and Methods: This survey was conducted in north west Tasmania over a 6-month period, during quarterly clinic visits. A well-known, reliable and validated survey tool -Paediatric Quality of life (PedsQL) Diabetes Module 3.0 was used to capture information about the diabetic specific HRQoL in children and adolescents. The parent-proxy version of the forms was completed by the parents electronically using iSurvey application to secure information regarding their children’s diabetes related symptoms (11 items), treatment barriers (4 items), treatment adherence (7 items), worry (3 items) and communication (3 items). All de-identified information was downloaded into an excel spreadsheet and SPSS V24.0 for further analysis.

Results: 34 parents completed the electronic data forms on iSurvey. There were no statistically significant differences in HRQoL among the CSII, MDI and fMDI groups as determined by one-way ANOVA in diabetes {F (2, 31) = 0.517, p = 0.601}, treatment {F (2, 31) = 0.385, p = 0.684}, worry {F (2, 31) = 0.076, p = 0.927}, and communication {F (2, 31) = 0.672, p = 0.518}.

Conclusion: Although, the impact of T1D on the HRQoL in children and adolescents is higher than the children without T1D, it appears to be independent of the types of three intensive insulin therapy generally used- CSII, MDI and fMDI, suggesting type of insulin therapy may not be the major influencing factor for children’ quality of life as revealed in this first of its kind study. A further study with higher number of participants and the additional impact of various glucose monitoring systems on the HRQoL is highly recommended, which may influence the decision of right therapy suitable for the entire family.