The role of personality factors and quality of life in the metabolic compensation of type 1 diabetes mellitus in adolescents

The growing prevalence of type 1 diabetes mellitus (T1D) in the adolescent age group and the deterioration of glycemic control in adolescence set new goals for the search for factors that affect the degree of metabolic compensation in adolescents. The purpose of the study. To compare the features of the personal profile and quality of life (QOL) with metabolic compensation in adolescent children with T1D using new high-tech treatment (NHTT) - flash monitoring of glycemia (FMG), an insulin pump with the function of predictive stop before the onset of hypoglycemia (IPPS). Materials and methods. The study involved 78 children with T1D aged 11-17 years. Group 1 included 30 patients using FMG, group 2 included 48 patients using IPPS. The follow-up period for patients was 3 months from the start of the use of NHTT. Metabolic control (MC) was assessed by the following indicators: glycated hemoglobin (HbA1c) level, time in range (TIR), time above range (TAR), time below range (TBR). The study of personal factors was conducted by testing the "Big Five Questionnaire" (BFQ), the Achenbach questionnaire, and the assessment of quality of life was conducted by the KINDL questionnaire. Results. The distribution of patients in group 1 according to the degree of compensation at the time of inclusion: 24 people had HbA1c>7.0%, 6 people had HbA1c<7.0%. When evaluating the parameters of MC at the 2nd visit after 3 months, patients with HbA1c>7.0% had a significantly higher TAR (p=0.003) and a significantly lower TIR (p=0.006). The method of linear regression revealed a statistically significant association between the severity of the "openness" scale assessed by the BFQ and the HbA1c level (b=-0.2464; p=0.006). There is a statistically significant negative association (p<0.05) between TIR and the presence of aggressive behavior in a teenager (b=-2.754; p=0.028), thought problems (b=3.542; p=0.008), as well as other somatic complaints (b=-4.07; p=0.003). The distribution of patients in 2 groups according to the degree of compensation at 1 visit: 32 people had HbA1c>7.0%, 16 people had HbA1c<7.0%. When assessing MC after 3 months, the group of initially compensated patients had a significantly higher level of TIR (p=0.003). Statistically significant associations were obtained between QOL (the level of physical well-being) and the level of "social problems" (b=-0.88; p=0.001). A statistically significant negative association was established between QOL in terms of "disease" and the scales "conscientiousness" (b=-0.177; p=0.03), "neuroticism" (b=-0.1043; p=0.022), and a positive association with the level of extraversion (b=0.1712; p=0.016). Conclusion. New high-tech diabetes therapies have higher efficacy in previously compensated patients. Adolescents with T1D who have higher intelligence, are more creative, have better metabolic compensation. The presence of a large number of somatic complaints and more aggressive behavior of a teenager is associated with worse metabolic compensation. Glycemic control parameters do not affect the quality of life of adolescents with diabetes. However, some personality traits affect the perception of quality of life.

type 1 diabetes mellitus, adolescents, metabolic control, quality of life, personal profile

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