Health-related quality of life of children and adolescents with type 1 diabetes during the COVID-19 pandemic in Kuwait

Affiliations

23 December 2022

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doi: 10.3389/fpubh.2022.1056967


Abstract

Background: With the rapid transmission of COVID-19 globally, countries have implemented strict governmental measures and social distancing rules that aimed to minimize the spread of the virus. School closures, quarantine orders, and social isolation, coupled with a surge in family stress and lack of peer interactions, are probable causes of mental health complications and psychological symptoms faced by children. This study aims at comparing the HRQoL of children and adolescents with type 1 diabetes (T1D) and affected by COVID-19 infection (personal or familial) and those who were not affected by COVID-19.

Materials and methods: A random sample was selected from children and adolescents diagnosed with T1D at the six major governmental diabetes centers in Kuwait. To measure HRQoL, parent-proxy and self-reports from the Pediatric Quality of Life Inventory (PedsQLTM) 3.0 Diabetes Module were used.

Results: A sample of 455 children and adolescents with T1D diabetes (44.6% male participants and 41.98% affected by COVID-19 infection) was studied. The total score of the HRQoL self-reports was significantly higher compared with parent-proxy reports (79.06 ± 15.19 vs. 73.79 ± 15.17, p < 0.01). Children reported significantly higher HRQoL scores in the "treatment I" domain and "worry" domain and lower scores in the "diabetes" symptoms domain, compared with their parents' reports (p < 0.01). In the COVID-19-affected group, a major difference was noticed between the total scores of children and parent-proxy reports (77.04 ± 15.81 vs. 72.80±14.90, p = 0.047). The affected children reported significantly lower scores in "diabetes" symptoms (59.50) (p < 0.01) and higher scores in the "treatment I" domain (81.43) than their parent-proxy reports (72.05) (p < 0.01).

Conclusion: This is the first report on the health-related quality of life of children with T1D in Kuwait during the COVID-19 era. Parents' or caregivers' experience of caring for their children was negative, as they worried, and reported poorer HRQoL compared with their children's perceptions. There is a need to empower healthcare professionals to support parents and caregivers of children with chronic diseases such as T1D in promoting self-management, enhancing physical and psychological wellbeing, treatment adherence, and continuous health education during pandemics of any kind.

Keywords: COVID-19; PedsQLTM Diabetes Module; children; health-related quality of life; type 1 diabetes.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


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References

  1.  
    1. Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: a meta-analysis. JAMA Pediatr. (2021) 175:1142–50. 10.1001/jamapediatrics.2021.2482 - DOI - PMC - PubMed
  2.  
    1. Xie X, Xue Q, Zhou Y, Zhu K, Liu Q, Zhang J, et al. . Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr. (2020) 174:898–900. 10.1001/jamapediatrics.2020.1619 - DOI - PMC - PubMed
  3.  
    1. Ravens-Sieberer U, Kaman A, Erhart M, Devine J, Schlack R, Otto C. Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry. (2021) 2021:1–11. 10.2139/ssrn.3721508 - DOI - PMC - PubMed
  4.  
    1. Danne T, Lanzinger S, de Bock M, Rhodes ET, Alonso GT, Barat P, et al. . A worldwide perspective on COVID-19 and diabetes management in 22,820 children from the SWEET project: diabetic ketoacidosis rates increase and glycemic control is maintained. Diabetes Technol Ther. (2021) 23:632–41. 10.1089/dia.2021.0110 - DOI - PubMed
  5.  
    1. Passanisi S, Pecoraro M, Pira F, Alibrandi A, Donia V, Lonia P, et al. . Quarantine due to the COVID-19 pandemic from the perspective of pediatric patients with type 1 diabetes: a web-based survey. Front Pediatr. (2020) 2020:491. 10.3389/fped.2020.00491 - DOI - PMC - PubMed
  6.  
    1. Al-Abdulrazzaq D, Alkandari A, Alhusaini F, Alenazi N, Gujral UP, Narayan KMV, et al. . Higher rates of diabetic ketoacidosis and admission to the paediatric intensive care unit among newly diagnosed children with type 1 diabetes in Kuwait during the COVID-19 pandemic. Diabetes Metab Res Rev. (2022) 38:e3506. 10.1002/dmrr.3506 - DOI - PMC - PubMed
  7.  
    1. McGurnaghan SJ, Weir A, Bishop J, Kennedy S, Blackbourn LA, McAllister DA, et al. . Risks of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland. Lancet Diab Endocrinol. (2021) 9:82–93. 10.1016/S2213-8587(20)30405-8 - DOI - PMC - PubMed
  8.  
    1. Diedisheim M, Dancoisne E, Gautier J-F, Larger E, Cosson E, Fève B, et al. . Diabetes increases severe COVID-19 outcomes primarily in younger adults. J Clin Endocrinol Metab. (2021) 106:e3364–e8. 10.1210/clinem/dgab393 - DOI - PMC - PubMed
  9.  
    1. Solowiejczyk J. The family approach to diabetes management: Theory into practice toward the development of a new paradigm. Diab Spectrum. (2004) 17:31–6. 10.2337/diaspect.17.1.31 - DOI
  10.  
    1. Control D, Group CTR. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Med. (1993) 329:977–86. 10.1056/NEJM199309303291401 - DOI - PubMed
  11.  
    1. Rochmah N, Faizi M, Hisbiyah Y, Triastuti IW, Wicaksono G, Endaryanto A. Quality of life differences in pre-and post-educational treatment in type 1 diabetes mellitus during COVID-19. Diab Metab Synd Obesity Targets Therapy. (2021) 14:2905. 10.2147/DMSO.S313575 - DOI - PMC - PubMed
  12.  
    1. Arab-Zozani M, Hashemi F, Safari H, Yousefi M, Ameri H. Health-related quality of life and its associated factors in COVID-19 patients. Osong Public Health Res Perspect. (2020) 11:296. 10.24171/j.phrp.2020.11.5.05 - DOI - PMC - PubMed
  13.  
    1. Varni JW, Burwinkle TM, Jacobs JR, Gottschalk M, Kaufman F, Jones KL. The PedsQL™ in type 1 and type 2 diabetes: reliability and validity of the Pediatric Quality of Life Inventory™ generic core scales and type 1 diabetes module. Diabetes Care. (2003) 26:631–7. 10.2337/diacare.26.3.631 - DOI - PubMed
  14.  
    1. Varni JW, Delamater AM, Hood KK, Driscoll KA, Wong JC, Adi S, et al. . Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes. Pediatr Diabetes. (2018) 19:1322–30. 10.1111/pedi.12713 - DOI - PMC - PubMed
  15.  
    1. Rubin RR. Diabetes and quality of life. Diabetes Spectr. (2000) 13:21.
  16.  
    1. Abdul-Rasoul M, AlOtaibi F, Abdulla A, Rahme Z, AlShawaf F. Quality of life of children and adolescents with type 1 diabetes in Kuwait. Medical principles and practice. (2013) 22:379–84. 10.1159/000347052 - DOI - PMC - PubMed
  17.  
    1. Abdul-Rasoul M, AlOtaibi F, AlMahdi M, AlKandari H. Reliability and validity of the Arabic version of the PedsQLTM 4.0 generic ore scales and PedsQLTM 3.0 diabetes module. J Diab Mellit. (2012) 2:301–7. 10.4236/jdm.2012.23047 - DOI
  18.  
    1. DiMeglio LA, Acerini CL, Codner E, Craig ME, Hofer SE, Pillay K, et al. . ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diab. (2018) 27:105–14. 10.1111/pedi.12737 - DOI - PubMed
  19.  
    1. Varni JW, Seid M, Rode C. PedsQL: Measurement model for the pediatric quality of life inventory Version. Med Care. (1998) 4:126–39. 10.1037/t65932-000 - DOI - PubMed
  20.  
    1. Kalyva E, Malakonaki E, Eiser C, Mamoulakis D. Health-related quality of life (HRQoL) of children with type 1 diabetes mellitus (T1DM): self and parental perceptions. Pediatr Diabetes. (2011) 12:34–40. 10.1111/j.1399-5448.2010.00653.x - DOI - PubMed
  21.  
    1. Varni JW,. Linguistic validation of the PedsQL—a Quality of Life Questionnaire. Mapi Research Institute (2002). Available online at: https://www.pedsql.org/PedsQL-Linguistic-Validation-Guidelines.doc (accessed August, 2022).
  22.  
    1. Boodai SA, Reilly JJ. Health related quality of life of obese adolescents in Kuwait. BMC Pediatr. (2013) 13:1–5. 10.1186/1471-2431-13-105 - DOI - PMC - PubMed
  23.  
    1. AlBuhairan F, Nasim M, Al Otaibi A, Shaheen NA, Al Jaser S, Al Alwan I. Health related quality of life and family impact of type 1 diabetes among adolescents in Saudi Arabia. Diabetes Res Clin Pract. (2016) 114:173–9. 10.1016/j.diabres.2016.01.001 - DOI - PubMed
  24.  
    1. Nardi L, Zucchini S, D'Alberton F, Salardi S, Maltoni G, Bisacchi N, et al. . Quality of life, psychological adjustment and metabolic control in youths with type 1 diabetes: a study with self-and parent-report questionnaires. Pediatr Diabetes. (2008) 9:496–503. 10.1111/j.1399-5448.2008.00414.x - DOI - PubMed
  25.  
    1. Graue M, Wentzel-Larsen T, Hanestad B, Båtsvik B, Søvik O. Measuring self-reported, health-related, quality of life in adolescents with type 1 diabetes using both generic and disease-specific instruments. Acta Paediatr. (2003) 92:1190–6. 10.1111/j.1651-2227.2003.tb02483.x - DOI - PubMed
  26.  
    1. Odeh R, Gharaibeh L, Daher A, Kussad S, Alassaf A. Caring for a child with type 1 diabetes during COVID-19 lockdown in a developing country: Challenges and parents' perspectives on the use of telemedicine. Diabetes Res Clin Pract. (2020) 168:108393. 10.1016/j.diabres.2020.108393 - DOI - PMC - PubMed
  27.  
    1. Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health. (2020) 4:e10–e1. 10.1016/S2352-4642(20)30108-5 - DOI - PMC - PubMed