Glycemic status and health-related quality of life of type 1 diabetic children in Kuwait during the COVID-19 pandemic

ABSTRACT

Introduction: The alarming spread of the COVID-19 virus caused governments to impose imperative lockdowns and quarantines which negatively impacted vulnerable Type 1 diabetes children. Objectives: The study aim was to assess glycemic status and healthrelated quality of life (HRQoL) during the pandemic in a cohort of children with Type 1 diabetes (T1D) in Kuwait. Methods: Patients (aged 2-18) and their parents were recruited from the Childhood-Onset Diabetes electronic Registry (CODeR) and government hospitals. The Pediatric Quality of Life Inventory (PedsQL™) 3.0 Diabetes Module was used to evaluate disease specific total HRQoL through parent-proxy and self-reports. HbA1c results between February 24, 2020 and March 24, 2021 were collected from hospital records to assess glycemic status. Results: A total of 150 patients were included in the study (age 9.5 ±3.5 years, 51% males, diabetes duration 3.4±2.3 years). From the surveyed participants, 119 (84%) were on multiple daily injections, 26 (19%) had T1D family history and 132 (90%) were cared by both parents. Determined from 59 available results, mean HbA1c was 9.78%±1.61. Parent-proxy and patient HRQoL reports were similar in score (73.1±13.9 and 73.3±11.8). Patients reported lower QoL in the diabetes symptoms domain (p=0.04) and a higher QoL in the treatment barriers domain (p=0.002). Gender, nationality, and age did not affect HRQoL. Pump therapy and longer diabetes duration (>3 years) were associated with higher parent-proxy total HRQoL (p=0.01, p=0.03). Patients cared by both parents had slightly better glycemic status (9.6%±1.5 vs 10.9%±2.3) and better QoL scores in the diabetes symptoms domain (p=0.04). No statistical association was found between either HbA1c or COVID-19 history and total HRQoL. Conclusions: In this study, history of personal or family COVID-19 infection did not affect HRQoL. However, special support needs to be given to patients recently diagnosed with T1D, cared for by single parents, and treated with MDI to have a better HRQoL during the pandemic.