The effect of medical and socioeconomic factors on health-related quality of life of children and families with type 1 diabetes mellitus: A research article

Abstract Background The aim of our study was to evaluate health-related quality of life (HRQL) in type 1 diabetes mellitus (T1DM) children and their families in Hungary. Parallelly our goal was to identify the effect of multiple factors (gender, age, diabetes specific factors). We examined effect of socioeconomic factors on perceptions of HRQL. Methods Between June and December 2024, a total of 130 children aged 2-17 and their parents completed PedsQL TM 4.0 Generic Core Scales (GCS), 2.0 Family Impact Module (FIM) and a socioeconomic questionnaire edited by our working group. To explore the HRQL score differences between the groups we used Mann-Whitney U and Kruskal Wallis test after normality testing. Results The results demonstrated that T1DM children and their families have slightly lower HRQL scores than the international and Hungarian general population. We found the lowest scores in the emotional functioning dimension (self-report (SR) 67.86±19.33, parent proxy-report (PPR) 69.00±19.33) in GCS and in physical (61.27±20.61), emotional functioning (61.80±21.80), worry (62.25±22.19) and daily activities (63.22±26.22) dimensions in FIM. The results indicated that female gender, older age, usage of insulin pump and good glycemic control were associated with better general and family HRQL scores. Significant difference was proved between usage of insulin pump compared with pen in PPR (pump: 81.12±14.48, pen: 76.48±13.59, p:0.035). Family HRQL scores were significantly reduced in younger ages (2-4y: 45.14±6.38, 5-7y: 58.57±18.51, 8-12y: 68.85±15.83, 13-17y: 72.72±15.38, p<0.001). Socioeconomic factors had a strong effect on both general and family HRQL scores. We found significantly lower general HRQL scores among parents with lower levels of education, in case of maternal unemployment, with overcrowded housing and with lack of own car. Conclusions Our findings confirm the previously described positive effect of the usage of insulin pump on HRQL. We find strong negative effect of the chronic disease on families with young children and poor socioeconomic status. Our findings highlight the need for comprehensive support—from medical and psychological services as well as civil society and government organizations—for young people and those living in adverse social conditions. Trial Registration retrospectively registered in 08.06. in 2026 10.17605/OSF.IO/F6DP4