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Endocrinología, Diabetes y Nutrición (English ed.)
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Inicio Endocrinología, Diabetes y Nutrición (English ed.) Influence of socioeconomic factors on glycemic control, therapeutic adherence an...
Journal Information
Vol. 71. Issue 6.
Pages 253-262 (June - July 2024)
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Vol. 71. Issue 6.
Pages 253-262 (June - July 2024)
Original article
Influence of socioeconomic factors on glycemic control, therapeutic adherence and quality of life in children and adolescents with type 1 diabetes
Influencia de factores socioeconómicos sobre el control glucémico, la adherencia terapéutica y la calidad de vida en niños y adolescentes con diabetes mellitus tipo 1
Carmen Yoldi-Vergaraa,
Corresponding author
carmen.yoldi@sjd.es

Corresponding author.
, Ignacio Conget-Donlob,c,d, Roque Cardona-Hernandeza, Marta Ramon-Krauela,e
a Servicio de Endocrinología Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain
b Servicio de Endocrinología y Nutrición, Hospital Clinic i Universitari, Barcelona, Spain
c Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
d Institut d’investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
e Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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Tables (4)
Table 1. Description of the participants’ metabolic control, adherence level, and quality of life.
Table 2. Socioeconomic characteristics of participant patients and their families (n = 323).20
Table 3. Description of diabetes-related quality of life (PedsQl scale), according to the type of family in which children and adolescents with T1DM lived and the primary responsible parent for supervising diabetes care.
Table 4. Linear regression model for HbA1c and DMQ-Sp in children and adolescents with T1DM (n = 323).
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Additional material (1)
Abstract
Objective

To stablish the relationship between socioeconomic status of a cohort of children and adolescents with type 1 diabetes (T1D) with glycemic control, therapeutic adherence and diabetes quality of life (DQoL).

Patients y methods

A cross-sectional, observational study with consecutive inclusion was carried out. Participants aged 8–18 years with T1D duration >1 year. Data on family structure, family income, parents’ educational level and parental role on primary diabetes care supervision were registered. Adherence (DMQ-Sp) and DQoL (PedsQl) were analyzed. Linear and logistic regression models adjusted for demographics, family structure and parental role on primary diabetes care responsibility were applied.

Results

A total of 323 patients (T1D duration 5,3 ± 3,3 years; HbA1c 7,7 ± 1,0%; age 13,3 ± 2,8 years; 49,8% females) were included. Patients living in a nuclear family and those whose main diabetes care supervision was shared by both parents showed lower HbA1c [adjusted for demographics and family structure (7,06; CI 95% 6,52–7,59); adjusted for demographics and role on primary diabetes care supervision (7,43; CI 95% 6,57–8,28)]. DMQ-Sp score (adjusted for demographics and role on main supervision) was higher in patients whose parents shared the diabetes care supervision (84,56; CI 95% 73,93–95,19). Parents sharing diabetes care supervision showed a significantly higher PedsQl score (both 74,63 ± 12,70 vs mother 68,53 ± 14,59; p = 0,001).

Conclusions

Children and adolescents with T1D had lower HbA1c, better therapeutic adherence and better DQoL when lived in a nuclear family, with higher socioeconomic status and the responsibility for supervising diabetes care was shared by both parents.

Keywords:
Type 1 diabetes
Pediatrics
Socioeconomic status
Adherence
Quality of life
Glycemic control
Resumen
Objetivo

Analizar la relación entre los factores socioeconómicos en que conviven una cohorte de niños y adolescentes con diabetes tipo 1 (DT1) con el grado de control glucémico, adherencia terapéutica y calidad de vida (CVRD).

Pacientes y métodos

Estudio transversal, observacional de inclusión consecutiva. Participaron pacientes (edad 8–18 años) con DT1 > 1 año de evolución. Se registró el tipo de estructura familiar, ingresos económicos familiares, nivel de estudios de los progenitores y progenitor responsable primario de la supervisión del cuidado de la diabetes. Se analizó el grado de adherencia (DMQ-Sp) y CVRD (PedsQl). Se aplicaron modelos de regresión lineal ajustados por datos demográficos, estructura familiar y responsable primario.

Resultados

323 participantes con DT1 (edad 13,3 ± 2,8 años; evolución 5,3 ± 3,3 años; HbA1c 7,7 ± 1,0%; 49,8% mujeres). La HbA1c (ajustada por demográficos y estructura familiar) fue menor en los pacientes que convivieron en una familia nuclear (7,06; IC 95% 6,52–7,59), y menor (ajustada por demográficos y progenitor responsable primario) en aquellos cuyos progenitores compartían esa responsabilidad (7,43; IC 95% 6,57–8,28). La puntuación DMQ-Sp (ajustada por demográficos y responsabilidad) fue mayor en los pacientes cuyos progenitores compartían la supervisión (84,56; IC 95% 73,93–95,19). Los progenitores mostraron mayor ponderación PedsQl en el grupo que compartían la supervisión (ambos 74,63 ± 12,70; madre 68,53 ± 14,59; p = 0,001).

Conclusiones

Los niños y adolescentes con DT1 presentaron una HbA1c más baja, mejor adherencia terapéutica y CVRD cuando convivieron en una familia con estructura nuclear, con nivel socioeconómico elevado y la responsabilidad de la supervisión del cuidado de la diabetes fue compartida por ambos progenitores.

Palabras clave:
Diabetes tipo 1
Pediatría
Nivel socioeconómico
Adherencia
Calidad de vida
Control glucémico

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