Endocrine Abstracts

Background: Long-standing type 1 diabetes, had many complications which have an impact on both life expectancy and quality of life of these patients. The aims of our study were to evaluate the quality of life of a group of Tunisian patients with type 1 diabetes evolving for more than 20 years as well as to determine the factors associated with its alteration.

Methods: We conducted a descriptive observational cross-sectional study including type 1 diabetic patients who had diabetes for more than 20 years, followed at the National Institute of Nutrition. Quality of life was assessed using the version 19 of the Audit of Diabetes Dependent Quality of Life (ADDQOL-19), translated into Tunisian dialect; which includes, in addition to two general questions, 19 questions specifically assessing 19 life domains. From these 19 questions, a weighted composite score was calculated. We considered that quality of life was impaired if this score was ≤-3.

Results: A total of 155 patients with a mean age of 39.7 ± 9.8 years were included in the study. The diabetes had progressed for 27.33 ± 6.38 years. The sex ratio M/F was 0.49. More than half of the population (53.4%) had an impaired quality of life with a mean composite score of -3.22 ± 2.19. Of the nineteen life domains assessed, thirteen had a mean score ≤-3. Fear of the future, physical ability and freedom to eat, were the most impaired life dimensions. Their mean scores were -4.39±3.4, -4.09±2.9 and -3.91±3.2, respectively. Univariate analysis showed that impaired quality of life was associated with unemployment (P=0.02), low level of education (P=0.049), low socioeconomic status (P=0.009), frequency of hypoglycemia (P<0.001), complicated retinopathy (P=0.037), peripheral neuropathy (P=0.012), disorders of the lower urinary tract (P=0.047) and category of risk of foot ulceration (P=0,028).

Conclsion: Our study highlights that after more than 20 years of the diagnosis of type 1 diabetes, the quality of life is often impaired. Prevention of chronic complications, psychological management, and adoption of therapeutic techniques that preserve dietary autonomy, could improve the QOL of long-standing type 1 diabetic patients.