While the adolescents in our study reported generally positive quality of life, there was substantial variation among individual adolescents in quality of life. Thus, our data agree with others that while IDDM is a risk factor for
psychological disorders in adolescents, the majority of teenagers do well (25). Adolescents,especially girls, are more prone to depression in general (26), as are female patients with diabetes (27). Adolescents in our study who were depressed were more likely to report poorer quality of life in all three areas measured. Thus, depression can be considered a marker for problems in quality of life in teenagers with diabetes.Girls worry more about their diabetes than
do boys, and therefore, could be at higher risk for depression.As has been reported previously, quality of life is not associated with metabolic control (8,9). Further, quality of life is not associated with treatment regimen, so that more injections per day as may be recommended in intensified treatment regimens may not be associated with poorer (or better)quality of life in this age-group. Our data suggest that metabolic control as measured by HbAlc is not a sufficient indicator of treatment success in adolescents.Quality of life must be considered separately from the metabolic treatment goals of diabetes care. Interestingly, neither age nor duration of diabetes was associated with higher HbAlc. This finding may be due to the more limited age range of the subjects in this study as compared with other studies of youth with diabetes. Several other researchers have also shown that adolescents whose parents maintain some guidance and control in the management of diabetes have better metabolic control (28-30). Thus, continuing to involve parents appropriately, with shared management, is associated with improved control. The challenge is to find the degree of parental involvement that is comfortable for all involved, without risking poorer control from overinvolvement or underinvolvement.In contrast to previous studies(20,30,31), our data did not demonstrate that family warmth and caring behaviors,adaptability or cohesion were associated with quality of life. It may be that these adolescents have already negotiated a degree of involvement that is comfortable for them, and thus, family involvement does not interfere with their quality of life.These data were collected as baseline data for a larger study involving intensifying their diabetes treatment regimen. Those
teenagers who did not consent to participate may not have negotiated a comfortable degree of family involvement.