title: Regional and urban Victorian diabetic youth: clinical and quality-of-life outcomes.
abstract: OBJECTIVE
  To compare groups of urban and regional Victorian diabetic children and assess their quality of life, diabetes knowledge, access to services and metabolic control.
  
  
  METHODS
  Forty-seven children from three regional Victorian communities (Horsham, Warrnambool and Sale; n = 16, 18 and 13, respectively) were compared with 120 age-, sex- and duration of diabetes-matched children attending the Royal Children's Hospital (RCH) diabetes clinic in Melbourne. Quality of life, diabetes knowledge, use of services, and metabolic control were assessed using the child health questionnaire (CHQ PF-50/CF-80); a diabetes-knowledge questionnaire; access to a diabetes nurse educator (DNE), dietitian and complication screening; and indices of mean HbA1C (values are taken every 3 months in the 'yearly HbA1C'), respectively.
  
  
  RESULTS
  Comparisons of CHQ data showed that regional diabetic youth scored significantly lower on most subscales. The greatest deficits were seen in areas of mental health, self-esteem, parent impact (emotional) and family cohesion. Diabetes knowledge and median yearly HbA1C for patients were not significantly different between the regional and urban centres (8.1%, 8.9%, 8.4% and 8.6% at RCH, Horsham, Warrnambool and Sale, respectively). Patients in regional centres had reportedly less access to team-based diabetes care.
  
  
  CONCLUSIONS
  Regional youth in Victoria, with similar levels of metabolic control and diabetes knowledge as their urban counterparts, have a markedly lower quality of life, implying a negative synergy between diabetes and the demands of regional lifestyles.
authors.affiliation: Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Australia. cameronf@cryptic.rch.unimelb.edu.au
authors.forename: F J
authors.initials: FJ
authors.lastname: Cameron
authors.forename: C
authors.initials: C
authors.lastname: Clarke
authors.forename: K
authors.initials: K
authors.lastname: Hesketh
authors.forename: E L
authors.initials: EL
authors.lastname: White
authors.forename: D F
authors.initials: DF
authors.lastname: Boyce
authors.forename: V L
authors.initials: VL
authors.lastname: Dalton
authors.forename: J
authors.initials: J
authors.lastname: Cross
authors.forename: M
authors.initials: M
authors.lastname: Brown
authors.forename: N H
authors.initials: NH
authors.lastname: Thies
authors.forename: G
authors.initials: G
authors.lastname: Pallas
authors.forename: P W
authors.initials: PW
authors.lastname: Goss
authors.forename: G A
authors.initials: GA
authors.lastname: Werther
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008019:Life Style; D008297:Male; D011788:Quality of Life; D012423:Rural Health; D012648:Self Care; D012649:Self Concept; D014504:Urban Health; D014739:Victoria
chemical_list: D006442:Glycated Hemoglobin