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Unhealthy lifestyle habits and diabetes-specific health-related quality of life in youths with type 1 diabetes

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Abstract

Aims

Management of type 1 diabetes mellitus (T1DM) influences several aspects of life, such as adherence to healthy lifestyle habits and health-related quality of life (HRQoL). Our aim was to evaluate the association between unhealthy lifestyle habits and HRQoL in adolescents and young adults with T1DM.

Methods

Two hundred and forty-two Caucasian patients (13–19 years) consecutively enrolled over a 12-month period in three Regional Pediatric Diabetes Centers in Italy. Demographics, clinical, and laboratory parameters, adherence to lifestyle habits (Mediterranean Diet assessed by KIDMED, Physical Activity levels and sedentary behavior by questionnaire) considered either separately or in cluster, and HRQoL by Pediatric Quality of Life Inventory Diabetes Module (PedsQL 3.0 DM) were collected. Metabolic control was determined by HbA1cmean of previous year.

Results

Only 15 (6.2%) patients fulfilled the cluster of three healthy lifestyle habits without gender differences (p = 0.353); 62 (25.6%) had 1 unhealthy lifestyle habit, and 165 (68.2%) had ≥2. Adolescents meeting physical activity recommendations had better PedsQL scores than those who did not meet. PedsQL total score and specific sub-scales decreased in patients with unhealthy lifestyle habits. High PedsQL was significantly associated with being male, living in South Italy, having lower HbA1c mean levels, and reporting lower adherence to unhealthy lifestyle habits.

Conclusions

The clustering of unhealthy lifestyle habits is associated with reduced HRQoL in adolescents and young adults with T1DM. Promoting multiple behavior changes may be a useful approach to improve the health status and the HRQoL in youths with T1DM.

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Acknowledgements

This research was funded by Fondo Linea progettuale n. 7 “Tutela della maternità e promozione dell’appropriatezza del percorso nascita. Diagnosi precoce e cura delle alterazioni del metabolismo glucidico in età evolutiva”, D.C.A. n. 94 del 2013, Azienda Ospedaliera Universitaria Federico II di Napoli.

Author contributions

EM and EZ contributed to the study design and data interpretation, drafted, and edited the manuscript. EM, EZ, EDN, GM, and MM provided data collection and interpretation and edited the manuscript. CM, SZ, and AF contributed to the data analysis and interpretation, and edited the manuscript. GV designed the study, performed the statistical analyses and data interpretation, drafted and edited the manuscript. GV is the guarantor of this work and, as such, has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Author notes

  1. Enza Mozzillo and Eugenio Zito have equally contributed to the paper.

Authors and Affiliations

  1. Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Naples, Italy

    Enza Mozzillo, Eugenio Zito, Elena De Nitto & Adriana Franzese

  2. Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy

    Claudio Maffeis & Marco Marigliano

  3. Endocrine Unit, Department of Pediatrics, S. Orsola-Malpighi Hospital, Bologna, Italy

    Giulio Maltoni & Stefano Zucchini

  4. Department of Movement Sciences and Wellbeing, University of Naples Parthenope, via Medina 40, 80133, Naples, Italy

    Enza Mozzillo & Giuliana Valerio

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  1. Enza Mozzillo
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  2. Eugenio Zito
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Correspondence to Giuliana Valerio.

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No potential conflicts of interest relevant to this article were reported.

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The study has been approved by the Ethics Committees of all participating centers, in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all the parents and/or patients prior to their inclusion in the study.

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Mozzillo, E., Zito, E., Maffeis, C. et al. Unhealthy lifestyle habits and diabetes-specific health-related quality of life in youths with type 1 diabetes. Acta Diabetol 54, 1073–1080 (2017). https://doi.org/10.1007/s00592-017-1051-5

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  • DOI: https://doi.org/10.1007/s00592-017-1051-5

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