Increased risk of impaired treatment satisfaction among girls/women and young people with suboptimal HbA1c: Results of a nationwide type 1 diabetes study

Abstract

This study aims to analyze the patient-reported outcome (PRO) of treatment satisfaction in a sample of children, adolescents and young adults with long-duration type 1 diabetes and to determine potential risk factors for poor treatment satisfaction and the intraindividual changes over a 3-year period. This study used data from two population-based questionnaire surveys conducted in 2015–2016 and 2018–2019. The participants were 11 to 27 years old and had a type 1 diabetes duration of 10 years or longer in 2015–2016 (n = 575). Factors that were potentially associated with poor treatment satisfaction (moderate, poor or very poor) compared to the reference group (very good or good treatment satisfaction) were analyzed by log binomial regression adjusted for sex and age group. In 2015–2016 (2018–2019), 26% (33%) of the respondents rated their diabetes treatment/consultation as "very good", 53% (46%) as "good", and 20% (21%) as "poor". Based on the 2018–2019 data, girls/women had an increased risk of poor treatment satisfaction (RR_girls/women: 1.64 (1.10; 2.44), p = 0.016). In addition, people with hemoglobin A1c (HbA1c) values ≥ 7.5% had a more than twice the risk of poor treatment satisfaction than people with HbA1c values < 7.5% (RR_{HbA1c ≥7.5%}: 2.43 (1.63; 3.63), p < 0.001). A total of 42% of people with poor treatment satisfaction in 2015–2016 also reported poor treatment satisfaction at follow-up. Most study participants were satisfied with their diabetes treatment. However, we identified risk groups that would benefit from targeted interventions to improve this important PRO.