title: Emotional, behavioral and cognitive profile, and quality of life of Indian children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  The psychological stress associated with type 1 diabetes (T1D) may be higher in children from developing world due to limited health resources. The aims of the study were to assess the quality of life (QoL), emotional well-being, behavioral, and cognitive profile of children/adolescents with T1D diagnosed at least 6 months prior.
  
  
  METHODS
  Forty-nine children with T1D, aged 6-18 years were assessed using DAWN Youth QoL questionnaire, WHO-5 Well-Being Index, Child Behavior Checklist (CBCL), and Malin's Intelligence Scale for Indian children (MISIC). The association of the scores was studied with age, gender, socioeconomic status (SES), frequency of hypoglycemia, HbA1c, and age of onset and duration of T1D.
  
  
  RESULTS
  The mean (standard deviation (SD)) for DAWN QoL, WHO-5, CBCL, and MISIC scores was 24.7 (16.7), 74.6 (19.4), 52.6 (8.8), and 96.0 (11.2), respectively. The significant associations noted were: Elevated HbA1c with poorer emotional well-being; higher negative impact on 'symptoms of disease' and 'future prospects' sub-areas of QoL; shorter duration of disease with more behavioral issues; lower maternal education with more 'withdrawn/depressed' behaviors and 'worry about future prospects'; and lower SES with lower MISIC scores. Earlier onset (age <5 years) was associated with fewer behavioral problems and less negative impact on QoL.
  
  
  CONCLUSIONS
  Children with recent diagnosis, older age at onset, lower maternal educational level, elevated HbA1c, or belonging to lower SES were identified to have higher prevalence of various psychological and cognitive problems. In resource-limited settings, these children should be prioritized for behavioral and cognitive evaluation.
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Kriti
authors.initials: K
authors.lastname: Puri
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Savita
authors.initials: S
authors.lastname: Sapra
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India ; Division of Pediatric Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vandana
authors.initials: V
authors.lastname: Jain
keywords: Behavior; children; cognition; quality of life; type 1 diabetes