Skip to main content
Log in

Quality of Life in First Nation Youth with Type 2 Diabetes

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

To assess quality of life (QOL) in youth with type 2 diabetes, to compare youth and parent-proxy perceptions of youth QOL, to determine if youth QOL is associated with diabetes control, and to determine if demographic and/or medical history is associated with youth QOL and/or diabetes control. The study was quantitative and cross-sectional with a descriptive correlational approach. We administered the Pediatric QOL Inventory 4.0™ (PedsQL 4.0™) and the Pediatric QOL 3.0 Diabetes Module™ (PedsQL 3.0™) questionnaires to 28 youth with type 2 diabetes aged 7–18 and their parents attending a regional diabetes program in Winnipeg, Manitoba that serves a large geographic region of central Canada. We examined QOL scores for the generic and diabetes specific tools, and for correlation between the child and parent scores. We examined youth QOL scores along with medical and family history variables for their predictive value on diabetes control as measured by the glycosylated hemoglobin A1C value. Youth with type 2 diabetes reported higher scores in all domains of the generic and diabetes-specific tools compared to their parent report, indicating that the youth were more optimistic about their health-related QOL than their parents. The youth and their parents reported lowest QOL scores in the school-functioning, Worry and Communications scales related to diabetes. Living in remote communities, family experience with complications of diabetes, duration of diabetes, high A1C, and oral medications (but not insulin) had a negative impact on specific domains. First Nation youth with type 2 diabetes have a higher QOL than is perceived by their parents. QOL may be affected by specific demographic and clinical factors that may be modifiable to reduce the psychosocial burden of illness. These findings have implications for designing counseling strategies for adolescents with type 2 diabetes and their parents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Sawyer, S. M., Drew, S., Yeo, M. S., & Britto, M. T. (2007). Adolescents with a chronic condition: Challenges living, challenges treating. The Lancet, 369, 1481–1489. doi:10.1016/S0140-6736(07) 60370-5.

    Article  Google Scholar 

  2. Fagot-Campagna, A., Pettitt, D. J., Engelgau, M. M., Burrows, N. R., Geiss, L. S., Valdez, R., et al. (2000). Type 2 diabetes among North American children and adolescents: An epidemiologic review and public health perspective. Journal of Pediatrics, 136, 664–672. doi:10.1067/mpd.2000.105141.

    Article  PubMed  CAS  Google Scholar 

  3. Dean, H. J., Wood-Steiman, P., Flett, B., & Young, T. K. (1998). Screening for type 2 diabetes in Aboriginal children in Northern Canada. The Lancet, 353, 1523–1524. doi:10.1016/S0140-6736(05) 60329-7.

    Article  Google Scholar 

  4. Harris, S. B., Perkins, B. A., & Whalen-Brough, E. (1996). Non-insulin dependent diabetes mellitus among First Nations children: New entity among First nations people of northwestern Ontario. Canadian Family Physician, 42, 869–876.

    PubMed  CAS  Google Scholar 

  5. Dean, H. J., & Sellers, E. A. C. (2003). Type 2 diabetes in youth in Manitoba, Canada 1986–2002. Canadian Journal of Diabetes, 27, 449–454. www.diabetes.ca/section_professionals/cjd-dec03.asp. Accessed 20 August 2007.

    Google Scholar 

  6. Pinhas-Hamiel, O., & Zeitler, P. (2007). Acute and chronic complications of type 2 diabetes mellitus in children and adolescents. The Lancet, 369, 1823–1831. doi:10.1016/S0140-6736(07) 60821-6.

    Article  Google Scholar 

  7. Diabetes Control and Complications Trial Research Group. (1988). Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). Diabetes Care, 11, 725–732. doi:10.2337/diacare.11.9.725.

    Article  Google Scholar 

  8. de Wit, M., Delemarre-van de Waal, H. A., Pouwer, F., Gemke, R. J., & Snoek, F. J. (2007). Monitoring health related quality of life in adolescents with diabetes: A review of measures. Archives of Disease in Childhood, 92, 434–439. doi:10.1136/adc.2006.102236.

    Article  PubMed  Google Scholar 

  9. Varni, W. J., Jacobs, J. R., & Seid, M. (2000). Treatment adherence as a predictor of health-related quality of life. In D. M. Drotar (Ed.), Promoting adherence to medical treatment in chronic childhood illness: Concepts, methods, and interventions (pp. 287–305). NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  10. Blanchard, J., Dean, H. J., Anderson, K., Wajda, A., Ludwig, S., & Depew, N. (1997). The incidence and prevalence of diabetes in Manitoba 1985–1993 in children less than 15 years of age. Diabetes Care, 20, 512–517. doi:10.2337/diacare.20.4.512.

    Article  PubMed  CAS  Google Scholar 

  11. Varni, J. W., Burwinkle, T. M., Jacobs, J. R., Gottschalk, M., Kaufman, F., & Jones, K. L. (2003). The Peds QL in type 1 and type 2 diabetes. Diabetes Care, 26, 631–637. doi:10.2337/diacare.26.3.631.

    Article  PubMed  Google Scholar 

  12. Kuczmarski, R. J., Ogden, C. L., Grumm-Strun, L. M., et al. (2000). CDC growth chart. United States National Center for Health Statistics.

  13. Sellers, E. A. C., & Dean, H. J. (2004). Short term insulin therapy in youth with type 2 diabetes. Journal of Pediatric Endocrinology and Metabolism, 17, 1561–1564.

    PubMed  CAS  Google Scholar 

  14. Davis, E., Nicolas, C., Waters, E., Cook, K., Gibbs, L., Gosch, A., et al. (2007). Parent-proxy and child reported health related quality of life: Using qualitative methods to explain the discordance. Quality of Life Research, 16, 863–871. doi:10.1007/s11136-007-9187-3.

    Article  PubMed  Google Scholar 

  15. Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). Impaired health-related quality of life in children and adolescents with chronic conditions: A comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQLTM 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5, 43. doi:10.1186/1477-7525-5-43.

  16. Guttmann-Bauman, I., Flaherty, B. P., Strugger, M., & McEvoy, R. C. (1998). Metabolic control and quality-of-life self-assessment in adolescents with IDDM. Diabetes Care, 21, 915–918. doi:10.2337/diacare.21.6.915.

    Article  PubMed  CAS  Google Scholar 

  17. Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQL 4.0 as a pediatric population health measure: Feasibility, reliability and validity. Ambulatory Pediatrics, 3, 329–341. doi:10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2.

  18. Lawrence, J. M., Standiford, D. A., Loots, B., Klingensmith, G. J., Williams, D. E., Ruggiero, A., et al. (2006). Prevalence and correlates of depressed mood among youth with diabetes: The SEARCH for Diabetes in Youth study. Pediatrics, 117, 1348–1358. doi:10.1542/peds.2005-1398.

    Article  PubMed  Google Scholar 

  19. The TODAY study group. (2007). Treatment options for type 2 diabetes in adolescents and youth: A study of the comparative efficacy of metformin alone or in combination with rosiglitazone or lifestyle intervention in adolescents with type 2 diabetes. Pediatric Diabetes, 8, 74–87. doi:10.1111/j.1399-5448.2007.00237.x.

    Article  Google Scholar 

Download references

Acknowledgments

The authors are grateful for the support of the pediatric diabetes team of the Diabetes Education Resource for Children and Adolescents at the Winnipeg Children’s Hospital, Winnipeg, Manitoba, Canada and to Dr Elizabeth Sellers for her constructive comments on the manuscript. Research Funding: Interdisciplinary Health Research Team of the Canadian Institute for Health Research (PI: Dr Kue Young, University of Toronto; co-investigator H. Dean).

Author contributions

Cindy Allan completed this study as part of the requirement for her Master’s degree in nursing from the University of North Dakota. She planned, executed, collected the data and did the analysis and drafted the first manuscript. Bertha Flett, the study research assistant, participated in all aspects of the implementation of the study in the field including recruitment, obtaining consents, administration of the quality of life questionnaires and helping with data extraction. Heather Dean as the Principal Investigator was involved in all aspects of the study and served as on-site supervisor for the Master’s student performance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Heather J. Dean.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Allan, C.L., Flett, B. & Dean, H.J. Quality of Life in First Nation Youth with Type 2 Diabetes. Matern Child Health J 12 (Suppl 1), 103–109 (2008). https://doi.org/10.1007/s10995-008-0365-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-008-0365-x

Keywords

Navigation