P-217: Quality of life and glycemic control in pre-transition youth with type 1 diabetes across treatment modalities
E Niechcial, P Wais, A Kowalewska, D Lenartowska, A Kędzia, M Izbaner, K Cyranka, D Zozulinska-Ziolkiewicz, A AraszkiewiczAbstract
Introduction
Quality of life is a key outcome in pediatric T1D and may be influenced by glycemic control, treatment modality, and disease duration. Understanding these relationships in pre-transition youth is essential for optimizing care.
Objectives
To evaluate how glycemic control, treatment type, and disease duration relate to health-related quality of life (HRQoL) measured with the KIDSCREEN questionnaire in a large cohort of pre-transition adolescents with T1D.
Methods
We analyzed clinical data, 14-day continuous glucose monitoring metrics, and KIDSCREEN scores. Disease duration was categorized as <5, 5–10, and >10 years. Treatment groups included MDI vs. CSII and HCL vs. non-HCL. Glycemic control was classified according to international consensus thresholds. Standard statistical tests were applied.
Results
A total of 164 participants were included (99 boys). At baseline, participants had a mean age at diagnosis of 9.7 years and a disease duration of 8.2 years. Their average glucose level was 163 mg/dL, with TIR of 63%, TBR level 1 of 2.8% and level 2 of 0.8%, and TAR level 1 of 22% and level 2 of 11.2%. The CV was 36.2%, and the estimated GMI was 7.2%. Higher TIR was associated with better HRQoL, particularly in physical and psychological well-being. Children with lower TBR and lower TAR reported more favorable HRQoL, especially in the KIDSCREEN domains of physical well-being, psychological well-being, autonomy and parent relations, and school environment. Participants treated with CSII and HCL demonstrated higher TIR and tended to report better HRQoL than those on injections or non-HCL. Shorter disease duration was associated with more favorable HRQoL, while sex differences were minimal.
Conclusions
Glycemic control, treatment modality, and disease duration are important determinants of HRQoL in pre-transition youth with T1D. Achieving recommended glycemic targets and using advanced treatment approaches may improve well-being in this population.