目的:为了稳定儿童和青少年1型糖尿病(T1D)患者的社会经济状况与血糖控制之间的关系,治疗依从性和糖尿病生活质量(DQoL)。
■横截面,我们进行了连续纳入的观察性研究.参与者年龄在8-18岁,T1D持续时间>1年。有关家庭结构的数据,家庭收入,对父母的教育水平和父母在初级糖尿病护理监督中的作用进行了登记。分析粘附性(DMQ-Sp)和DQoL(PedsQl)。针对人口统计进行调整的线性和逻辑回归模型,应用家庭结构和父母对初级糖尿病护理责任的作用。
结果:共包括323例患者(T1D持续时间5,3±3,3年;HbA1c7,7±1,0%;年龄13,3±2,8岁;49,8%女性)。生活在核心家庭中的患者和父母双方共同接受主要糖尿病护理监督的患者显示HbA1c较低[根据人口统计学和家庭结构进行调整(7,06;CI95%6,52-7,59);根据人口统计学和对初级糖尿病护理监督的作用进行调整(7,43;CI95%6,57-8,28)]。父母共同接受糖尿病护理监督的患者的DMQ-Sp评分(根据人口统计学和主要监督角色进行调整)较高(84,56;CI95%73,93-95,19)。共享糖尿病护理监督的父母显示出明显更高的PedsQl得分(均为74,63±12,70,而母亲为68,53±14,59;p=0,001)。
结论:患有T1D的儿童和青少年HbA1c较低,当生活在一个核心家庭中时,更好的治疗依从性和更好的DQoL,具有较高的社会经济地位和监督糖尿病护理的责任由父母双方共同承担.
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).
UNASSIGNED: 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.