Skip to main content
    • Aa
    • Aa


  • Andrea Lukács (a1), Emőke Kiss-Tóth (a1), Beatrix Varga (a2), Andrea Soós (a3), Peter Takác (a1) and László Barkai (a4)...

Purpose: The aim of this study was to compare the general health-related quality of life (HRQoL), the metabolic control (HbA1c), the anthropometric measurement, and the cardiorespiratory fitness (expressed by VO2max) in youths with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) to those receiving multiple daily injections (MDI). We looked for factors influencing the HRQoL and metabolic control.

Methods: A total of 239 patients treated with CSII (51 girls and 53 boys) or MDI (64 girls and 71 boys) between ages 8 and 18 years were assessed with the Pediatric Quality of Life Inventory, Generic Core Scales, and Diabetes Module. VO2max was evaluated using the 20-meter shuttle run test.

Results: CSII group had significantly better HRQoL according to both child self-report and parent proxy-report. Youths with CSII reported better physical, emotional, and school-related functioning, and had less diabetes-related fear and symptoms than the MDI group. There were no significant differences in body mass index z-scores, insulin doses, HbA1c, and VO2max between the groups. HRQoL was predicted by the CSII therapy (β = −0.220; p = .000) and the VO2max (β = 0.386; p = .000), other clinical and anthropometric parameters had no effect; the HbA1c was predicted only by VO2max (β = −0.353; p = .000).

Conclusions: Diabetic youths treated with CSII therapy have better HRQoL than those treated with MDI. There are no differences between the investigated groups in anthropometric data, glycated hemoglobin, and physical fitness. Moreover, good physical fitness has an important role in achieving better metabolic control and HRQoL, which underlines the importance of regular aerobic exercise in the treatment and care of type 1 diabetes in childhood.

Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. G Soltesz , CC Patterson , G Dahlquist ; (EURODIAB Study Group). Worldwide childhood type 1 diabetes incidence – what can we learn from epidemiology? Pediatr Diabetes. 2007;8 (Suppl 6):614.

2. H-J Bangstad , T Danne , LC Deeb , et al.Insulin treatment in children and adolescents with diabetes (ISPAD Clinical Practice Consensus Guidelines 2009 Compendium). Pediatr Diabetes. 2009;10 (Suppl 12):8299.

3. WV Tamborlane , RS Sherwin , M Genel , P Felig . Reduction to normal of plasma glucose in juvenile diabetes by subcutaneous administration of insulin with a portable infusion pump. N Engl J Med. 1979;300:573–8.

4.Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus. J Pediatr. 1994;125:177–88.

6. DM Wilson , BA Buckingham , EL Kunselman , et al.A two-center randomized controlled feasibility trial of insulin pump therapy in young children with diabetes. Diabetes Care. 2005;28:15–9.

7. M Monami , C Lamanna , N Marchionni , E Mannucci . Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 1 diabetes: a meta-analysis. Acta Diabetol. 2010;47 (Suppl 1):7781.

9. E Cummins , P Royle , A Snaith , et al.Clinical effectiveness and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes: systematic review and economic evaluation. Health Technol Assess. 2010;14:iiiiv, xi–xvi, 1–181.

11.American Diabetes Association. Physical activity/exercise and diabetes mellitus. Diabetes Care. 2004;27 (Suppl 1):S5862.

12. NS Peirce . Diabetes and exercise. Br J Sports Med. 1999;33:161–73.

13. M Rigla , JL Sánchez-Quesada , J Ordóñez-Llanos , et al.Effect of physical exercise on lipoprotein(a) and low-density lipoprotein modifications in type 1 and type 2 diabetic patients. Metabolism. 2000;49:640–7.

14. WR Komatsu , MA Gabbay , ML Castro , et al.Aerobic exercise capacity in normal adolescents and those with type 1 diabetes mellitus. Pediatr Diabetes. 2005;6:145–9.

15. BK Williams , KJ Guelfi , TW Jones , EA Davis . Lower cardiorespiratory fitness in children with type 1 diabetes. Diabet Med. 2011;28:1005–7.

16. JW Varni , M Seid , PS Kurtin . PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001;39:800–12.

17. JW Varni , MA Burwinkle , JR Jacobs , et al.The PedsQL™ in type 1 and type 2 diabetes: reliability and validity of the Pediatric Quality of Life Inventory™ Generic Core Scales and type 1 Diabetes Module. Diabetes Care. 2003;26:631637.

18. LA Léger , D Mercier , C Gadoury , J Lambert . The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci. 1988;6:93101.

19. NY Liu , SA Plowman , MA Looney . The reliability and validity of the 20-meter shuttle test in American students 12 to 15 years old. Res Q Exerc Sport. 1992;63:360–5.

22. MJ Naughton , MS Ruggiero , JM Lawrence , et al.(SEARCH for Diabetes in Youth Study). Health-related quality of life of children and adolescents with type 1 or type 2 diabetes mellitus. Arch Pediatr Adolesc Med. 2008;162:649–57.

23. BW Bode , WV Tamborlane , PC Davidson . Insulin pump therapy in the 21st century. Strategies for successful use in adults, adolescents, and children with diabetes. Postgrad Med. 2002;111:6977.

24. E Pańkowska , M Błazik , P Dziechciarz , A Szypowska , H Szajewska . Continuous subcutaneous insulin infusion vs. multiple daily injections in children with type 1 diabetes: a systematic review and meta-analysis of randomized control trials. Pediatr Diabetes. 2009;10:52–8.

25. K Barnard , S Thomas , P Royle , K Noyes , N Waugh . Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. BMC Pediatr. 2010;10:50.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 8
Total number of PDF views: 14 *
Loading metrics...

Abstract views

Total abstract views: 262 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 28th March 2017. This data will be updated every 24 hours.