Background and Aims

Glycaemic parameters and quality of life (QOL) are important outcomes defined in clinical trials in individuals with type 1 diabetes (TID).

This study aims to explore the demographic and psychosocial factors that predict glycaemic outcomes i.e glycated haemoglobin (HbA1c) and time in range (TIR), and QOL in adolescents on contemporary therapy.

Methods

Adolescents and young adults with T1D and HbA1c <10.5% were eligible. Baseline demographic characteristics, glycaemic (HbA1c, TIR) and psychosocial measures using validated questionnaires (hypoglycaemia awareness, fear of hypoglycaemia, QOL and diabetes distress) were collected. TIR (3.9 to 10mmol/l) was obtained from masked sensor (Enlite® 3, Medtronic). Linear regression analyses were used to determine predictors of glycaemic control and QOL.

Results

Data were analyzed from 120 participants (46% males; 81% CSII; 66% CGM; 18% impaired hypoglycaemia awareness) with (mean±SD) age 15.1 ± 3.0 years, diabetes duration 7.1 ± 4.3 years and HbA1c 7.9 ± 1.0%. The median [IQR] TIR was 55.4% [44.1, 62.1].

A strong bivariate correlation was noted between HbA1c and TIR (p<0.001). Every 1% increase in HbA1c was associated with 7.9% reduction in TIR.

Lower fear of hypoglycaemia predicted improved HbA1c (p=0.025) although there was no correlation between HbA1c and other demographic and psychosocial measures. There was no correlation between TIR with any demographic and psychosocial measures (p>0.05).

Lower fear of hypoglycaemia (p=0.007) and diabetes distress (p<0.001) predicted an improved QOL.

Conclusions

The study provides a snapshot of the predictors of glycaemic outcomes and QOL in adolescents with T1D on contemporary therapy.