Analysis On The Impact Factors Of Self-management And Quality Of Life In Juveniles And Youths With Diabetes Mellitus In Jiangxi

Objective:This study aimed to investigate the glucose control,the status of self-manag-ement capacity,the correlation between self-management capacity and glucose control,the quality of life and impact factors in juveniles and youths with diabetes mellitus in Jiangxi province.Methods:1.119 juveniles and youths patients with diabetes mellitus aged 14 to 30 years were enrolled from January 2017 to December 2017(n=119)in the department of Endocrinology and Metabolism in the Second Affiliated Hospital of Nanchang University including 37 cases of type 1 diabetes(T1DM)and 82 cases of type 2diabetes(T2DM).All patients completed diabetes registration study case report form that included diabetes self-management behavioral scale and youth quality of life questionnaire.2.The general,clinical and serological characteristics of patients with T1 DM and T2 DM were compared by univariate analysis.Spearman correlation was used to analyze the correlation between self-management capacity and glucose control in juveniles and youths with diabetes.Estimations of crude Odds ratio(OR)and their95% confidence interval(95%CI)were calculated by logistic regression analysis for the scores of self-management behaviors and glycated hemoglobin A1c(Hb A1c).3.The impact factors of quality of life in juveniles and youths with T1 DM and T2 DM were analyzed by univariate analysis.Physiological function scores,emotional function scores,social function scores,role or school function scores and total quality of life are dependent variations.The meaningful impact factor and its relationship with quality of life was analyzed by multivariate linear regression analysis.Results:1.The mean Hb A1c in juveniles and youths with diabetes patients in Jiangxi was10.88%.Only 10.9% of patients on the basis of glycosylated hemoglobin A1c less than 7.0%.Among this patients,58.8% have hyperlipidemia,33.6% have hyperuricemia,10.1% have fatty liver and 3.4% have hypertension.2.It was showed that the scores of self-management behaviors of juveniles and youths with diabetes mellitus were negatively correlated with Hb A1c levels by Spearman correlation analysis.Binary logistic regression analysis manifested that Hb A1c was influenced by self-management behaviors.Common diet,exercise,compliance medication were attributed to Hb A1c level.3.Age,only child,duration of illness,and complications of diabetes were the impact factors of quality of life in juveniles and youths patients with T1 DM and T2 DM by univariate analysis.It was showed that age had negative impact on physiological function scores,emotional function scores,total quality of life scores of T1 DM patients,and on emotional function scores,role or school function scores,and total quality of life scores of T2 DM patients by multiple linear regression analysis.The duration of illness had negative influence on social function scores of T1 DM patients and emotional function scores,social function scores,role or school function scores,and total quality of life scores of T2 DM patients.The only child had positive impact on social function scores of T1 DM patients,and on physiological function scores,emotional function scores,role or school function scores,and total quality of life scores of T2 DM patients.Complications of diabetes had negative impact on physiological function scores and total quality of life scores in patients with T2 DM.Conclusions:1.Juveniles and Youths with diabetes have poor glucose control in Jiangxi province,only 10.9% for Hb A1c less than 7.0%.Patients with T1 DM who had Hb A1c less than 7.0% accounted for 13.5% and 9.8% whose Hb A1c was less than7.0% with T2 DM patients.2.The average score of self-management behaviors of juveniles and youths with diabetes in Jiangxi province was 26.The score of each part of self-management was negatively correlated with Hb A1c levels.Common diet,exercise,and medication compliance were favorable factors for blood glucose control in adolescents with diabetes mellitus.3.The score of life quality satisfaction in juveniles and youths with diabetes in Jiangxi province was 78.5.Age,only child,duration of illness and complications of diabetes were the predict-ors of life quality satisfaction in adolescents with diabetes.