A Cross-Sectional Study on Clinical Outcome of the Current Management Practice with Carb-Counting & Insulin Titration, & Health-Related Quality of Life (HRQoL) on a Selected Group of Young Adults with Type 1 Diabetes Attending to Diabetes & Endocrinology Unit at National Hospital Kandy, Sri Lanka

Background: Clinical outcome and health related quality of life (HRQoL) assessment among young adults living with type 1 diabetes mellitus (T1DM) following structured education on self-management of diabetes in Sri Lankan settings is unknown.
Aims: To assess the clinical outcomes of current management practice with carbohydrate counting and self-management of insulin according to eating patterns and to assess the health-related quality of life (HRQoL) among young adults living with T1DM aged between 18-25.
Methods: Thirty young adults aged between 18-25 years with the diagnosis of T1DM, classified according to American Diabetes Association guideline based on the clinical and/or biochemical parameters were recruited in this descriptive cross-sectional study. Basic demographic data, baseline and follow up assessments on HBA1C were recorded. HRQoL assessment was carried out via a self-administered questionnaire (ViDa1) and the results were compared for internal consistency and with the clinical outcomes.
Results: Among the 12 male and 18 female patients, an improvement in HBA1C by the mean of 1.2% was noted over a mean period of 11.38 months of carbohydrate counting and 9.52 months of the self-management of insulin, though no statistical significance observed (P=0.698, 95%CI -0.38-2.8). The internal consistency of Vida 1 questionnaire for our population was validated through Cronbach’s alpha > 0.7 in all four subclasses. There was a positive correlation between self-care and wellbeing (P<0.05) as well as wellbeing and concern about illness (P<0.05). The means for self-care and concern about illness were higher at 3.77 and 3.80 respectively. Feeling of wellbeing was associated with higher educational level (P<0.05).
Conclusion: Carbohydrate counting and self-management of insulin showed beneficial effects on improving the HbA1C, though there were no statistical significance. Higher educational level had statistically significant association with feeling of wellbeing in patient with T1DM, which could be explained by improvement in self-confidence with better understanding of training. By extending this study in multicentric level with larger sample size might improve the statistical significance in clinical outcome and further follow up study is required to assess the difference in HRQoL with time.