An Assessment of Quality of Life Among Children with Type 1 Diabetes Mellitus:A Cross-Sectional Study

Authors

  • Zarina Naz Department of Nursing, National University of Medical Sciences, Rawalpindi, Punjab, Pakistan.
  • Taslim Fatima CMH Multan Institute of Medical Sciences (CIMS), Punjab, Paksitan.
  • Aizza Ibrar Department of Orthodontics, de’Montmorency College of Dentistry, Lahore, Pakistan.
  • Pir Abrar Ahmad Raza Al-Nafees Medical College and Hospital, Islamabad, Pakistan.
  • Sohaila Sohu Pediatric Physical Therapist, Agha Khan University Hospital, Karachi, Sindh, Pakistan.
  • Eman Aslam Department of Medical Sciences, Wah Medical College, Wah Cantt, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i10.2593

Keywords:

Type 1 Diabetes Mellitus, Pediatric Quality of Life, Glycemic Control, Family Support, Psychosocial Factors, School Accommodations, Emotional well-being, Disease Management.

Abstract

Type 1 Diabetes Mellitus (T1DM) is a chronic metabolic disorder that significantly affects children’s physical, emotional, and social well-being. Quality of life (QoL) is an important outcome for pediatric patients, reflecting their ability to manage the disease while maintaining normal daily functioning, social participation, and psychological health. This cross-sectional study aimed to assess the quality of life among children with T1DM and to identify clinical, psychosocial, and environmental factors influencing their well-being. A quantitative approach was employed, collecting data from 150 children aged 6–18 years using the Pediatric Quality of Life Inventory (PedsQL 4.0), supplemented by clinical records and structured parent interviews. Data analysis included descriptive statistics, correlation analysis, and multiple regression to determine predictors of quality of life across physical, emotional, social, and school domains. Results indicated that children with good glycemic control, longer disease duration, strong family and peer support, and access to school accommodations reported higher quality of life, whereas poor glycemic control, high parental stress, and lack of social support were associated with lower QoL. The findings highlight the critical need for integrated care approaches that combine medical management with psychosocial support and educational interventions to optimize outcomes for pediatric T1DM patients.

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References

1. Bekele, B. T., Demie, T. G., & Worku, F. (2022). Health-related quality-of-Life and associated factors among children and adolescents with type 1 diabetes mellitus: A cross-sectional study. Pediatric Health, Medicine and Therapeutics, 13, 243-256.

https://doi.org/10.2147/phmt.s364454

2. Bas, V. N., & Bideci, A. (2011). Evaluation of factors affecting quality of life in children with type 1 diabetes mellitus. Journal of Diabetes & Metabolism, 02(08).

https://doi.org/10.4172/2155-6156.1000154

3. Mohammed, A. A., Awad Maabreh, R. S., Alrabab’a, M. H., Eyadat, A. M., & Hani, S. B. (2025). Quality of life among school-age children with type 1 diabetes mellitus: A cross-sectional study. SAGE Open Nursing, 11.

https://doi.org/10.1177/23779608251369588

4. Liu, J., Li, J., Li, L., & Zeng, K. (2025). Impact of family environment on mental disorders and quality of life in children with type 1 diabetes mellitus: A cross-sectional study and intervention policy analysis. Frontiers in Pediatrics, 13.

https://doi.org/10.3389/fped.2025.1516411

5. Butwicka, A., Fendler, W., Zalepa, A., Szadkowska, A., Zawodniak-Szalapska, M., Gmitrowicz, A., & Mlynarski, W. (2016). Psychiatric disorders and health-related quality of life in children with type 1 diabetes mellitus. Psychosomatics, 57(2), 185-193.

https://doi.org/10.1016/j.psym.2015.11.001

6. López-Bastida, J., López-Siguero, J. P., Oliva-Moreno, J., Vázquez, L. A., Aranda-Reneo, I., Reviriego, J., Dilla, T., & Perez-Nieves, M. (2019). Health-related quality of life in type 1 diabetes mellitus pediatric patients and their caregivers in Spain: An observational cross-sectional study. Current Medical Research and Opinion, 35(9), 1589-1595.

https://doi.org/10.1080/03007995.2019.1605158

7. Kumar, N., Singh, Y., Singh, S., & Rana, V. (2020). Quality of life of type 1 diabetic Indian children and adolescents-Cross sectional study. Int J Health Sci Res, 10(2), 1-9.

8. Bekele, B. T., Demie, T. G., & Worku, F. (2022). Determinants of quality of life in children and adolescents with Type-I diabetes mellitus: A cross-sectional study.

https://doi.org/10.21203/rs.3.rs-1657062/v1

9. Souza, M. A., Freitas, R. W., Lima, L. S., Santos, M. A., Zanetti, M. L., & Damasceno, M. M. (2019). Health-related quality of life of adolescents with type 1 diabetes mellitus. Revista Latino-Americana de Enfermagem, 27.

https://doi.org/10.1590/1518-8345.2961.3210

10. Moronkola, O. A., Oyenusi, E. E., Yarherhe, I., Bello, A., Renner, E., Ojo, F. I., ... & Oduwole, A. O. (2025). Health-Related Quality of Life in Children and Adolescents with Type 1 Diabetes Mellitus. The African Journal of Pediatric Endocrinology and Metabolism, 2(1), 10-17.

11. Núñez-Baila, M., Gómez-Aragón, A., Marques-Silva, A., & González-López, J. (2024). Exploring determinants of health-related quality of life in emerging adults with type 1 diabetes mellitus: A cross-sectional analysis. Nutrients, 16(13), 2059.

https://doi.org/10.3390/nu16132059

12. Alhaddad, J. A., Alshakes, N. A., & Aljasim, M. N. (2023). Quality of life among children with type 1 diabetes mellitus in Alahsa: A cross-sectional study. Cureus.

https://doi.org/10.7759/cureus.40766

13. Hilliard, M. E., Minard, C. G., Marrero, D. G., De Wit, M., Thompson, D., DuBose, S. N., Verdejo, A., Monzavi, R., Wadwa, R. P., Jaser, S. S., & Anderson, B. J. (2019). Assessing health-related quality of life in children and adolescents with diabetes: Development and psychometrics of the type 1 diabetes and life (T1DAL) measures. Journal of Pediatric Psychology, 45(3), 328-339.

https://doi.org/10.1093/jpepsy/jsz083

14. Mulyasari, R., Agustini, N., & Rustina, Y. (2019). Coping strategies and quality of life of children with type 1 diabetes mellitus: A preliminary study. Comprehensive Child and Adolescent Nursing, 42(sup1), 217-225.

https://doi.org/10.1080/24694193.2019.1594453

15. Mutlu, E. K., Mutlu, C., Taskiran, H., & Ozgen, I. T. (2015). Association of physical activity level with depression, anxiety, and quality of life in children with type 1 diabetes mellitus. Journal of Pediatric Endocrinology and Metabolism, 28(11-12).

https://doi.org/10.1515/jpem-2015-0082

16. Girma, D., Murugan, R., Wondossen, K., Yeshiwas, S., Wale, A., & Tilahun, S. (2021). Health-related quality of life and its associated factors in children and adolescents with Type1 diabetes, Addis Ababa, Ethiopia. Global Pediatric Health, 8.

https://doi.org/10.1177/2333794x211030879

17. Ichikawa, M., Yamakawa, T., Sakamoto, R., Takahashi, K., Suzuki, J., Matsuura-Shinoda, M., Shigematsu, E., Tanaka, S., Kaneshiro, M., Asakura, T., Kawata, T., Yamada, Y., Nezu Osada, U., Isozaki, T., Takahashi, A., Kadonosono, K., & Terauchi, Y. (2022). A cross-sectional study of the relationship between quality of life and sleep quality in Japanese patients with type 1 diabetes mellitus. Endocrine Journal, 69(4), 399-406.

https://doi.org/10.1507/endocrj.ej21-0408

18. Almomani, B. A., Elayyan, R. N., & Al-Shatnawi, S. F. (2025). Type 1 diabetes mellitus in children: Patient reported outcomes. PLOS One, 20(5), e0322882.

https://doi.org/10.1371/journal.pone.0322882

19. Park, H., & Park, S. (2025). Factors influencing quality of life in adolescents with type 1 diabetes mellitus: A cross-sectional study in South Korea. Belitung Nursing Journal, 11(3), 357-362.

https://doi.org/10.33546/bnj.3701

20. Naughton, M. J. (2008). Health-related quality of life of children and adolescents with type 1 or type 2 diabetes mellitus. Archives of Pediatrics & Adolescent Medicine, 162(7), 649.

https://doi.org/10.1001/archpedi.162.7.649

21. Vargas, D. M., Neis, M., & Azevedo, L. C. (2025). Fatores relacionados a qualidade de Vida Em adolescentes com diabetes mellitus tipo 1: Uma revisão sistemática. Physis: Revista de Saúde Coletiva, 35(3).

https://doi.org/10.1590/s0103-73312025350316pt

22. Alenazi, S. A., Alruwaili, S. M., Hashim, S. H. A., Haneif, I., Hussain, S., Alanazi, R. S. J., ... & Elmorsy, E. M. (2025). Quality of life in children and adolescents with type 1 Diabetes mellitus: Study from Saudi Arabia. Revista iberoamericana de psicología del ejercicio y el deporte, 20(1), 33-37.

23. Hegde, S., Tennelli, A. K., Priyanka, V., Venkat, V., Wesley, C. J., & Sajjan, S. (2025). Assessment Of Quality of Life in Type 1 Diabetes Mellitus Children. Journal of Contemporary Clinical Practice, 11, 302-306.

24. Chen, F., Fan, L., Li, X., Xie, Y., Li, J., Weng, H., Xu, R., & Liu, F. (2025). Dynamics and determinants of long-term quality of life in children and adolescents with type 1 diabetes: Real-world evidence from China. Quality of Life Research, 34(10), 2921-2934.

https://doi.org/10.1007/s11136-025-04025-7

25. Ben Abdesselem, I., Kebeili, R., Derbel, K., Ben Said, H., Boughamoura, L., Bouguila, J., & Ben Saad, H. (2025). Influencing factors of health-related quality-of-life perceived by both children/adolescents patients with type-1 diabetes mellitus and their parents: A North-African study. F1000Research, 13, 429.

https://doi.org/10.12688/f1000research.148074.2

26. Atitallah, S., Hassine, F., Yahyaoui, S., Ben Rabeh, R., Missaoui, N., Bouyahia, O., Mazigh, S., & Boukthir, S. (2025). Health-related quality of life and its influencing factors in children with type 1 diabetes in Tunisia: A cross-sectional study. BMJ Open, 15(7), e100825.

https://doi.org/10.1136/bmjopen-2025-100825

27. KAYIRANWA, A. (2016). Assessment of growth among children with Type 1 diabetes mellitus: A cross-sectional study of factors contributing to stunting (Doctoral dissertation, University of Rwanda).

28. João, P., Canta, A. C., & Mendes, S. (2025). Oral health-related quality of life, behaviours and oral manifestations in a paediatric population with type I diabetes mellitus: A comparative cross-sectional study. Dentistry Journal, 13(9), 425.

https://doi.org/10.3390/dj13090425

29. Tural Buyuk, E., Uzsen, H., Koyun, M., & Dönertaş, R. (2023). Parental monitoring status of the children with type 1 diabetes mellitus (DM) and their quality of life. International Journal of Diabetes in Developing Countries, 44(4), 687-693.

https://doi.org/10.1007/s13410-023-01304-2

30. Urzeală, C., Bota, A., Teodorescu, S., Vlăiculescu, M., & Baker, J. S. (2020). Quality of life in Romanian children with type 1 diabetes: A cross-sectional survey using an interdisciplinary healthcare intervention. Healthcare, 8(4), 382.

https://doi.org/10.3390/healthcare8040382

31. AlSaleh, A., Ahmed, J., Alsenani, I., Alhousni, W., AalAbdulsalam, R., & Alshammasi, M. T. (2025). Assessment of quality of life of children and adolescents with type 1 diabetes in Bahrain using PedsQL 3.2 diabetes module. Journal of Clinical Medicine, 14(7), 2216.

https://doi.org/10.3390/jcm14072216

32. Rochmah, N., Soetjipto, S., Faizi, M., Hisbiyah, Y., Perwitasari, R. K., Fedora, K., Rosyidah, L. N., Endarko, E., Kuswanto, D., & Rini, E. (2024). Frequent self-monitoring blood glucose correlated to better medication adherence and glycemic control in children with type 1 diabetes mellitus. Diabetes, Metabolic Syndrome and Obesity, 17, 2203-2209.

https://doi.org/10.2147/dmso.s448508

33. Dhiyaulhaq, H. N., Rochmah, N., Febriyana, N., & Kusumastuti, N. P. (2022). The comparison of quality of life in children with type 1 diabetes mellitus based on parents and children report. International Journal Of Scientific Advances, 3(6).

https://doi.org/10.51542/ijscia.v3i6.11

34. Beraki, Å., Magnuson, A., Särnblad, S., Åman, J., & Samuelsson, U. (2014). Increase in physical activity is associated with lower HbA1c levels in children and adolescents with type 1 diabetes: Results from a cross-sectional study based on the Swedish pediatric diabetes quality registry (SWEDIABKIDS). Diabetes Research and Clinical Practice, 105(1), 119-125.

https://doi.org/10.1016/j.diabres.2014.01.029

35. Gohal, G. A., Majhali, A., Moafa, E., Talebi, S. H., Maashi, B. I., Mutaen, A., Alhamdan, W. J., & Dighriri, I. M. (2024). Health-related quality of life of adolescents and children with type 1 diabetes in the Jazan region of Saudi Arabia. Cureus.

https://doi.org/10.7759/cureus.53307

36. Domínguez-Domínguez, A., Martínez-Guardado, I., Domínguez-Muñoz, F. J., Barrios-Fernandez, S., Morenas-Martín, J., Garcia-Gordillo, M. A., & Carlos-Vivas, J. (2021). Association between the level of physical activity and health-related quality of life in type 1 diabetes mellitus. A preliminary study. Journal of Clinical Medicine, 10(24), 5829.

https://doi.org/10.3390/jcm10245829

37. Cyranka, K., Juza, A., Kwiendacz, H., Nabrdalik, K., Gumprecht, J., Małecki, M., Klupa, T., & Matejko, B. (2023). Evaluation of psychological resources of young adults with type 1 diabetes mellitus during the transition from pediatric to adult diabetes clinics: Multicenter cross-sectional study. JMIR Formative Research, 7, e46513.

https://doi.org/10.2196/46513

38. Luo, D., Cai, X., Wang, H., Wang, Y., & Xu, J. (2024). The role of peer social relationships in psychological distress and quality of life among adolescents with type 1 diabetes mellitus: A longitudinal study. BMC Psychiatry, 24(1).

https://doi.org/10.1186/s12888-024-05692-5

39. Atay, C., Kaya Mutlu, E., Taskiran, H., & Ozgen, I. T. (2018). Comparison of hand function between children with type 1 diabetes mellitus and children without type 1 diabetes mellitus. Pediatric Physical Therapy, 30(1), 58-65.

https://doi.org/10.1097/pep.0000000000000465

40. Birkebaek, N., Kristensen, L., Mose, A., & Thastum, M. (2014). Quality of life in Danish children and adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion or multiple daily injections. Diabetes Research and Clinical Practice, 106(3), 474-480.

https://doi.org/10.1016/j.diabres.2014.09.028

41. Yang, J., Liu, Y., Cao, S., Wang, G., Zhou, H., Wang, Y., & Ai, Z. (2025). The status and influencing factors of health behavior self‐management in children with type 1 diabetes mellitus: A cross‐sectional study. Health Science Reports, 8(4).

https://doi.org/10.1002/hsr2.70700

42. Gunasekaran, S., Silva, M., O'Connell, M. A., Manton, D. J., & Hallett, K. B. (2022). Caries experience and gingival health in children and adolescents with type 1 diabetes mellitus—A cross‐sectional study. Pediatric Diabetes, 23(4), 499-506.

https://doi.org/10.1111/pedi.13324

43. Cheung, R., Young Cureton, V., & Canham, D. L. (2006). Quality of life in adolescents with type 1 diabetes who participate in diabetes camp. The Journal of School Nursing, 22(1), 53.

https://doi.org/10.1622/1059-8405(2006)22[53:qoliaw]2.0.co;2

44. Smith-Palmer, J., Bae, J., Boye, K., Norrbacka, K., Hunt, B., & Valentine, W. (2016). Evaluating health-related quality of life in type 1 diabetes: A systematic literature review of utilities for adults with type 1 diabetes. ClinicoEconomics and Outcomes Research, 8, 559-571.

https://doi.org/10.2147/ceor.s114699

45. Coolen, M., Broadley, M., Hendrieckx, C., Chatwin, H., Clowes, M., Heller, S., De Galan, B. E., Speight, J., & Pouwer, F. (2021). The impact of hypoglycemia on quality of life and related outcomes in children and adolescents with type 1 diabetes: A systematic review. PLOS ONE, 16(12), e0260896.

https://doi.org/10.1371/journal.pone.0260896

46. Almeida, A. C., Leandro, M. E., & Pereira, M. G. (2019). Family functioning and quality of life in adolescents with type 1 diabetes: The role of dissimilarity in illness representations and school support. Clinical Child Psychology and Psychiatry, 25(2), 494-506.

https://doi.org/10.1177/1359104519895054

47. Mrkulić, E., Mahmutović, J., Branković, S., Konjo, H., & Đido, V. (2025). Primary caregivers’ satisfaction with healthcare of children and adolescents with type 1 diabetes mellitus. Croatian nursing journal, 9(1), 19-28.

https://doi.org/10.24141/2/9/1/2

48. Bujang, M. A., Supramaniam, P., Haniff, J., Muninathan, P., Jalaludin, M. Y., Zain, F. M., & Hua, J. H. Y. (2013). The Association between Self-Care Practices, HbA1c and Quality of Life for Type 1 DM in Children and Adolescents. International Medical Journal, 20(3).

49. Firat, E., & Tuncay, T. (2018). The relationship between diabetes-related factors, family functioning and health-related quality of life in Turkish adolescents with type 1 diabetes mellitus. Child Care in Practice, 26(1), 81-93.

https://doi.org/10.1080/13575279.2018.1516624

50. Tonoli, C., Heyman, E., Roelands, B., Buyse, L., Cheung, S. S., Berthoin, S., & Meeusen, R. (2012). Effects of different types of acute and chronic (Training) exercise on Glycaemic control in type 1 diabetes mellitus. Sports Medicine, 42(12), 1059-1080.

https://doi.org/10.2165/11635380-000000000-00000

51. Tierney, S., Webb, K., Jones, A., Dodd, M., Mckenna, D., Rowe, R., Whitehouse, J., & Deaton, C. (2008). Living with cystic fibrosis-related diabetes or type 1 diabetes mellitus: A comparative study exploring health-related quality of life and patients' reported experiences of hypoglycaemia. Chronic Illness, 4(4), 278-288.

https://doi.org/10.1177/1742395308094240

52. Turin, A., & Drobnič Radobuljac, M. (2021). Psychosocial factors affecting the etiology and management of type 1 diabetes mellitus: A narrative review. World Journal of Diabetes, 12(9), 1518-1529.

https://doi.org/10.4239/wjd.v12.i9.1518

53. Rajan, R., Dovbenyuk, R., Kshatriya, M., Yanikomeroglu, S., Banfield, L., Athale, U., Thabane, L., & Samaan, M. C. (2025). The impact of virtual care on health-related quality of life in pediatric diabetes mellitus: A systematic review. Adolescent Health, Medicine and Therapeutics, 15, 109-117.

https://doi.org/10.2147/ahmt.s482859

54. Wong, L. C., Idris, A. N., Nor, N. K., & Lim, P. G. (2023). Behavioural and emotional problems in Malaysian children and adolescents with type 1 diabetes mellitus: A cross-sectional study in a single centre. Journal of the ASEAN Federation of Endocrine Societies, 38(2), 13-19.

https://doi.org/10.15605/jafes.038.02.10

55. Zeng, Z., Wang, X., Chen, Y., Zhou, H., Zhu, W., Xiong, X., Tang, J., & Zhao, Q. (2023). Health-related quality of life in Chinese individuals with type 2 diabetes mellitus: A multicenter cross-sectional study. Health and Quality of Life Outcomes, 21(1).

https://doi.org/10.1186/s12955-023-02183-1

56. Turton, J. L., Raab, R., & Rooney, K. B. (2018). Low-carbohydrate diets for type 1 diabetes mellitus: A systematic review. PLOS ONE, 13(3), e0194987.

https://doi.org/10.1371/journal.pone.0194987

57. Alotaibi, A., Al Khalifah, R., & McAssey, K. (2020). The efficacy and safety of insulin pump therapy with predictive low glucose suspend feature in decreasing hypoglycemia in children with type 1 diabetes mellitus: A systematic review and meta‐analysis. Pediatric Diabetes, 21(7), 1256-1267.

https://doi.org/10.1111/pedi.13088

58. Ghazaiean, M., Najafi, B., Zamanfar, D., & Alipour, M. J. (2024). Risk factors for suboptimal glycemic control in pediatrics with type 1 diabetes mellitus: A cross-sectional study. Scientific Reports, 14(1).

https://doi.org/10.1038/s41598-024-57205-9

59. Von Kobyletzki, L. B., Ulriksdotter, J., Sukakul, T., Aerts, O., Agner, T., Buhl, T., Bruze, M., Foti, C., Gimenez‐Arnau, A., Gonçalo, M., Hamnerius, N., Johansen, J. D., Rustemeyer, T., Stingeni, L., Wilkinson, M., & Svedman, C. (2024). Prevalence of dermatitis including allergic contact dermatitis from medical devices used by children and adults with type 1 diabetes mellitus: A systematic review and questionnaire study. Journal of the European Academy of Dermatology and Venereology, 38(7), 1329-1346.

https://doi.org/10.1111/jdv.19908

60. Triebl, Z., Bencze, B., Bányai, D., Rózsa, N., Hermann, P., & Végh, D. (2024). Poor glycemic control impairs oral health in children with type 1 diabetes mellitus - a systematic review and meta-analysis. BMC Oral Health, 24(1). https://doi.org/10.1186/s12903-024-04516-y

61.Rafique A, Yasin N, Hanif A, Matloob J, Khan AA, Sanaullah S, et al. Comparative Analysis of Inflammatory Markers (CRP, TLC, ESR) between Gestational Diabetes and Non-Diabetic Pregnant Females in Rawalpindi, Pakistan. Indus Journal of Bioscience Research. 2025;3(8):245-50.

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Published

2025-10-30

How to Cite

Naz, Z., Fatima, T., Ibrar, A., Raza, P. A. A., Sohu, S., & Aslam, E. (2025). An Assessment of Quality of Life Among Children with Type 1 Diabetes Mellitus:A Cross-Sectional Study. Indus Journal of Bioscience Research, 3(10), 397-405. https://doi.org/10.70749/ijbr.v3i10.2593