Association of individual and area-level socioeconomic conditions with quality of life and glycaemic control in 11- to 21-year-old adolescents with early-onset type 1 diabetes: a cross-sectional study
To analyse the association of area-level deprivation (German Index of Multiple Deprivation, GIMD 2010) with health- and disease-related quality of life (QoL) and glycaemic control (HbA1c) jointly with individual-level socioeconomic status (SES) in young patients with preschool-onset type 1 diabetes.
A total of 425 male and 414 female patients aged 11–21 years from a Germany-wide population-based survey completed the generic KINDL-R, the DISABKIDS chronic-generic module (DCGM-12), and the DISABKIDS diabetes-specific module with impact and treatment scales (QoL indicators; range 0–100 with higher scores representing better QoL). To analyse the association of area-level deprivation and SES with QoL and HbA1c, multiple linear regression models were applied adjusting for sociodemographic and health-related variables.
Mean QoL scores (SD) were 73.2 (12.2) for the KINDL-R, 76.1 (16.1) for the DCGM-12, 66.2 (19.9) for diabetes impact, and 56.4 (27.3) for diabetes treatment (DISABKIDS). Mean HbA1c was 8.3 (1.4)%. While both QoL outcomes and HbA1c level improved with increasing individual SES, no association was observed between area-level deprivation (GIMD 2010) and either outcome.
Compared with individual SES, area-level deprivation seems to be of minor importance for QoL and glycaemic control in young people with early-onset type 1 diabetes.
KeywordsType 1 diabetes Adolescents Quality of life HbA1c Area-level deprivation Socioeconomic status
We thank all our participants for completing the questionnaires and the diabetes care teams throughout Germany for forwarding the questionnaires to their patients. Furthermore, we thank our colleagues at the German Diabetes Center for their faithful support during data collection and entry.
The German Diabetes Center receives institutional funding from the German Federal Ministry of Health (BMG) and the Ministry of Science and Research of the State of North Rhine-Westphalia (MIWF NRW). The ‘Clinical Course of Type 1 Diabetes in Children, Adolescents and Young Adults with Disease Onset in Preschool Age’ study is a prospective study supported by grants (Grant Numbers: 01GI0802, 01GI1109A, 01GI0859, 01GI1106) from the German Competence Network for Diabetes mellitus and the German Center for Diabetes Research (DZD, Grant Number: 82DZD00201) [both funded by the German Federal Ministry of Education and Research (BMBF)]. The current project was especially supported by a grant from the German Center for Diabetes Research (DZD). The DPV initiative (assisting in forwarding the study documents to eligible patients) is supported by the European Foundation for the Study of Diabetes (EFSD) and the Dr. Bürger-Büsing Foundation, in addition to the German Center for Diabetes Research (DZD). The funders were not involved in the study design, the data collection, the data analyses, the manuscript preparation, nor in the decision to submit the article for publication.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest relevant to this article.
The type 1 diabetes study was carried out in accordance with the ethical standards laid down in the Declaration of Helsinki. The study was approved by the ethical review board at Heinrich-Heine-University Düsseldorf.
All patients and, in the case of minors, additionally their legal guardians, gave their written informed consent to participate in the study.
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