Diabetes-specific variables associated withquality of life changes in young diabetic people: The type 1 diabetes Registry of Turin (Italy)

Background and aims: Type 1 diabetes (T1DM) affects young people during the most active years of their life. Our aim was to assess quality of life (QoL) and associated variables in a large cohort of adults with childhood-onset and adult-onset T1DM. Methods: A cohort of adult patients (18 years and older) from the T1DM Registry of Turin, Italy, was recruited. Clinical characteristics and Diabetes QoL (DQOL) questionnaire were assessed by standardized procedures. Results: 310 adults completed the questionnaire. Age and diabetes duration at assessment (mean±SD) were 32.8±7.3 years and 17.3±6.3 years, respectively. DQOL and its subscores were in the lower quartiles of their distributions, indicating a good level of QoL. However, scores were significantly higher in females than in males, particularly for the subscale of diabetes-related worries. In multivariate analysis, lower QoL was independently associated with female sex (β=1.07, 95% CI 1.03-1.11, p=0.003), higher age at onset (β=1.03, 1.00-1.05, p=0.009), lower schooling (β=1.05, 1.00-1.09, p=0.02), higher fasting plasma glucose (β=1.03, 1.01-1.05, p=0.008), daily SMBG >4 (β=1.06, 1.01-1.10, p=0.01), severe hypoglycemia over the last year (β=1.06, 1.01-1.11, p=0.02), lower numbers of diabetologic visits (β=1.07, 1.01-1.13, p=0.02) and hypertension (β=1.06, 1.02-1.10, p=0.005). Autonomic neuropathy was associated with diabetes impact. Female sex (β=4.36, 2.43-7.83) and daily SMBG >4 (β=3.77, 1.72-8.30) were independently associated with worst level and CSII with better level (β=0.22, 0.07-0.68) of diabetes-related worries. Conclusions: The impact of T1DM on QoL may depend on demographic, metabolic control-related variables, presence of complications and insulin delivery modality.