传感器血糖监测时代 1 型糖尿病青少年及其父母的低血糖恐惧与生活质量
Fear of hypoglycemia and quality of life in young people with type 1 diabetes and their parents in the era of sensor glucose monitoring.
机构信息
Pediatric Endocrinology and Diabetology, University Children's Hospital Basel, and Department of Clinical Research, University of Basel, Basel, Switzerland.
Medical School, University of Basel, Basel, Switzerland.
出版信息
Front Endocrinol (Lausanne). 2022 Jul 28;13:958671. doi: 10.3389/fendo.2022.958671. eCollection 2022.
INTRODUCTION
It is crucial to understand psychosocial outcomes in children and adolescents with type 1 diabetes (T1D) and their families to provide optimal family-centered care. Hence, the aim of this study was to explore psychosocial outcomes in young people with T1D and their parents using currently available glucose monitoring devices in a real-life clinic setting.
METHODS
Children and adolescents aged 2-18 years with T1D for more than 6 months and their parents were recruited into a cross-sectional study to complete the Hypoglycemia Fear Survey (HFS) and the Pediatric Quality of Life Inventory (PedsQL) Generic Score Scales, Diabetes Module and Family Impact Module. Demographics and diabetes-specific parameters were obtained from medicals records.
RESULTS
Fifty-nine children and adolescents (mean age 15.1 ± 3.0 years) and 49 parents of children (mean age of children 12.5± 3.3 years) of which 44 were child-parent dyads completed the questionnaires. Parents had a higher mean (SD) FOH total and worry subscore than children, total score was 37.9 (14.6) vs. 32.2 (11.9), p = 0.047 and worry subscore was 17.8 (10.4) vs. 12.8 (9.0), p = 0.01. Furthermore, lower parental diabetes-specific QoL score was observed in parents, 78.8 (12.2) vs. 82.7 (10.3), p=0.02. No difference in FOH and QoL between real-time continuous glucose monitoring (rtCGM) and intermittently scanned glucose monitoring (isCGM) users and users of devices with and without alerts was observed. In isCGM users (n=36 completing the child questionnaires, n=33 completing parent questionnaires), higher parental FOH and lower parental diabetes-specific QoL correlated with higher scanning frequency, r = 0.399, p = 0.021, and r = -0.464, p = 0.007 respectively. No significant correlation was documented between scanning frequency and child questionnaire scores.
CONCLUSIONS
Parents are more likely to perceive higher levels of psychosocial burden related to their child's diabetes than children and adolescents with T1D, especially parents of younger children. This highlights the need for family-based education and treatment resources to support parents in diabetes management in addition to rapidly advancing diabetes technology. In isCGM users, higher parental FOH and lower parent-perceived QoL correlated with a higher scanning frequency, indicating the potential impact of glucose monitoring modality on psychosocial outcomes or vice versa.
简介
了解 1 型糖尿病（T1D）患儿及其家庭的心理社会结局对于提供最佳的以家庭为中心的护理至关重要。因此，本研究的目的是在真实临床环境中使用现有的血糖监测设备探讨青少年 T1D 患者及其父母的心理社会结局。
方法
招募了年龄在 2-18 岁、T1D 患病时间超过 6 个月的儿童和青少年及其父母进行横断面研究，完成了低血糖恐惧调查（HFS）和儿科生活质量量表（PedsQL）通用评分量表、糖尿病模块和家庭影响模块。从病历中获取人口统计学和糖尿病特定参数。
结果
59 名儿童和青少年（平均年龄 15.1 ± 3.0 岁）和 49 名儿童的父母（平均年龄 12.5± 3.3 岁）完成了问卷调查。其中 44 对是儿童-父母二联体。父母的 FOH 总分和担忧子得分均高于儿童，总分 37.9（14.6）比 32.2（11.9），p=0.047；担忧子得分 17.8（10.4）比 12.8（9.0），p=0.01。此外，父母的糖尿病特定 QoL 评分也较低，父母为 78.8（12.2）比 82.7（10.3），p=0.02。实时连续血糖监测（rtCGM）和间歇性扫描血糖监测（isCGM）使用者之间以及有和没有报警装置的使用者之间在 FOH 和 QoL 方面无差异。在 isCGM 用户（n=36 完成儿童问卷，n=33 完成父母问卷）中，较高的父母 FOH 和较低的父母糖尿病特定 QoL 与较高的扫描频率相关，r = 0.399，p = 0.021，r = -0.464，p = 0.007。未记录到扫描频率与儿童问卷评分之间的显著相关性。
结论
与青少年 T1D 患者相比，父母更有可能感知到与孩子糖尿病相关的更高水平的心理社会负担，尤其是年龄较小的孩子的父母。这凸显了需要以家庭为基础的教育和治疗资源来支持父母管理糖尿病，同时还需要快速推进糖尿病技术。在 isCGM 用户中，较高的父母 FOH 和较低的父母感知 QoL 与较高的扫描频率相关，表明血糖监测模式对心理社会结局的潜在影响，或者反之亦然。
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