The Relationship Among Executive Functioning, Health-Related Quality of Life, and Glycemic Control in Pediatric Type 1 Diabetes

The purpose of this study was to examine the relationship between glycemic control, executive functioning, and health-related quality of life in pediatric type 1 diabetes, as well as the impact of sex and age on these variables. Adolescents (N = 191) ages 12 to 18, both male and female, and their caregivers were asked to complete the Pediatric Quality of Life (generic form), the Comprehensive Executive Functioning Inventory, and to provide demographic and medical history information. Recent HbA1c, the number of diabetic ketoacidosis episodes, the number of hospitalizations, and a history of ketones, seizures, and hypoglycemia were obtained from the participant’s medical record to assess glycemic control. Results indicated that executive functioning was a significant predictor of the variance of self-report health-related quality of life. When glycemic control was added to the model, executive functioning also significantly predicted parent-report health-related quality of life. Additionally, glycemic control, executive functioning, and health-related quality of life were found to significantly covary with one another. Moreover, there were significant negative correlations between HbA1c, number of DKA episodes, number of hospitalizations in the past 6 months, number of hospitalizations since diagnosis and executive functioning. Regarding glycemic control and quality of life, there were significant negative correlations between HbA1c, number of DKA episodes, hospitalizations in the past 6 months, and hospitalizations since diagnosis with health-related quality of life scales. Finally, there were significant positive correlations between all executive functioning scales and all health-related quality of life scales. Of note, child’s current age did not predict nor was it significantly associated with glycemic control or executive functioning. Child’s sex had small significant associations with number of hospitalizations and emotion regulation, but did not predict executive functioning or glycemic control. Results demonstrate the importance of considering executive functioning when evaluating and treating glycemic control and health-related quality of life in pediatric type 1 diabetes