Factors Affecting Quality of Life in Adolescents Living with Type 2 Diabetes: A Sub study of The Improving renal Complications in Adolescents with type 2 diabetes through REsearch cohort

Background Type 2 diabetes (T2D) impacts adolescents living in challenging socioeconomic conditions disproportionately. However, impacts of T2D on quality of life (QOL) in this context are unknown. The objective of this study was to evaluate QOL, and identify its biological, psychological, and social determinants amongst adolescents living with and without T2D from similar sociodemographic backgrounds. Relationships between glycemic stability, early complications and treatments of T2D and QOL were also examined. Research design and methods A total of 92 adolescents with T2D and 59 at-risk controls were included from the iCARE cohort. Main outcome was QOL (Pediatric QOL Inventory™ (PedsQLTM). Biological covariates: age, sex, BMI z-score, HbA1C, eGFR and urine albumin:creatinine ratio (ACR). Psychological factors: perceived stress (PSS-14) and mental distress (Kessler-6). Social factors: food security (Household food security survey module), and income quintile. Multivariate linear regression analyses were used to identify factors associated with QOL between adolescents with and without T2D, and within the T2D cohort. Results Mean total QOL scores among adolescents with T2D were lower than controls (67.0 ±14.8 vs 71.7 ± 16.2, p=0.04). Age, sex and % Indigenous ethnicity were not significantly different between groups. Mean duration of T2D was 2.3± 2.0 yrs. In multivariate analysis, QOL was not associated with diabetes status, but negative associations were seen between mental distress (β =-1.46, p<0.001) and food insecurity QOL (β =-6.26, p=0.037). No differences were seen between biological factors and QOL in either analysis. Conclusions Significant factors associated with decreased QOL in adolescents living with T2D include mental distress and food insecurity, indicating areas for targeted intervention.