Disease-specific quality of life and associated health outcomes among children with diabetes in Khartoum state, sudan: a cross-sectional study

Abstract

Diabetes mellitus is a prevalent non-communicable disease that adversely affects multiple dimensions of quality of life in children and adolescents. This study aimed to assess disease-specific quality of life (Ds-QoL) among children with diabetes and to identify associated demographic and clinical factors. A cross-sectional study was conducted in 2020–2021 in major paediatric diabetes clinics in Khartoum, Sudan. A total of 138 children with diabetes and their parents were recruited using systematic random sampling. Disease-specific quality of life was assessed using the Paediatric Quality of Life Inventory (PedsQL) 3.0 Diabetes Module. Demographic, clinical, and care-related variables were analysed using bivariate tests and multivariable models, including generalized linear modelling. Participants had a mean age of 11.1 ± 3.6 years; 64% were female, and 74.6% resided in urban areas. Type 1 diabetes was predominant (92.8%), and glycaemic control was poor in 92.3% of participants (mean HbA1c = 9.38 ± 2.59%). Children reported higher overall Ds-QoL scores than 2 pa r ents (75.35 ± 12.02 vs. 70.82 ± 15.94). Significant child–parent differences were observed in diabetes symptoms ( p = 0.003) and worry ( p < 0.001), while communication scores were comparable. Increasing age was associated with greater treatment burden ( r = − 0.332, p < 0.001) and diabetes-related worry ( r = − 0.254, p = 0.004). Sociodemographic variables were not significantly associated with overall Ds-QoL. Hospitalization, hypoglycaemia, and diabetic ketoacidosis were associated with lower child-reported Ds-QoL, whereas regular follow-up was associated with higher Ds-QoL. In multivariable analysis, hypoglycaemia (B = − 4.97, p = 0.027) and diabetic ketoacidosis (B = − 6.48, p = 0.012) independently predicted poorer child-reported Ds-QoL. At the same time, glycaemic control was the only independent predictor of parent-reported Ds-QoL ( p = 0.001). Diabetes-specific quality of life in children is primarily influenced by clinical stability and acute complications rather than sociodemographic factors. Integrating child and parent perspectives and strengthening follow-up and metabolic control may improve quality-of-life outcomes.