title: Long-term impact of childhood-onset type 1 diabetes on social life, quality of life and sexuality.
abstract: OBJECTIVE
  This study describes the socio-professional outcomes, health-related quality of life (HRQOL) and sexuality of adults with childhood-onset type 1 diabetes (T1D).
  
  
  METHODS
  The study participants (n=388), recruited from a nationwide registry (age: 28.5 ± 3.1 years; T1D duration: 17.0 ± 2.7 years), completed a questionnaire (198 items); the results were compared with the French general population using standardized incidence ratios (SIRs) and Z scores matched for age, gender and period with/without education levels and patterns of family life. Linear regression models also investigated correlates of SF-36 Physical (PCS) and Mental Composite Scores (MCS).
  
  
  RESULTS
  Compared with the French general population, education levels of people with T1D were similar, with 68.6% having at least a high-school diploma or higher (SIR: 1.06, 95% CI: 0.93; 1.20), as were also their patterns of family life. Unemployment was higher in T1D women (15.3%, SIR: 1.50, 1.00; 2.05), but not in T1D men (8.6%, SIR: 0.96, 0.51; 1.57). Social discrimination was more common (SIR: 5.64, 4.64; 6.62), and frequency of daily alcohol consumption was higher (SIR: men, 3.34, 2.38; 4.54; women, 6.53, 4.57; 12.99). PCS and MCS were decreased moderately (mean ± SD: 52.0 ± 7.5; mean Z score: -0.2, 95% CI: -0.3; -0.1) and substantially (mean ± SD: 42.1 ± 12.4; mean Z score: -0.7, -0.8; -0.6), respectively. Fatigue and abandoning sports were predictive of a lower HRQOL. Both men and women were more frequently dissatisfied with their sex life. Prevalence of sexual problems was higher in women (SIR for: dysorgasmia, 1.91, 1.21-2.88; decreased/loss of desire: 2.11, 1.35-3.08), but similar in men. Participants with T1D-related complications had preserved social outcomes, but altered HRQOL.
  
  
  CONCLUSIONS
  Young adults with T1D have satisfactory social participation. However, their higher alcohol consumption, lower MCS and frequent dissatisfaction with sexuality suggest a heavy impact of the disease on morale, especially in women. Improving the everyday well-being of these young adults represents a key challenge for diabetes healthcare.
authors: Univ Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, 75010 Paris, France; Inserm, ECEVE U1123 et CIC-EC, CIC 1426, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France. Electronic address: helene.mellerio@inserm.fr.
authors: H
authors: H
authors: Mellerio
authors: Univ Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, 75010 Paris, France; Inserm, ECEVE U1123 et CIC-EC, CIC 1426, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France.
authors: S
authors: S
authors: Guilmin-Crépon
authors: Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Médecine de l'adolescent, 75019 Paris, France.
authors: P
authors: P
authors: Jacquin
authors: Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France.
authors: M
authors: M
authors: Labéguerie
authors: Inserm, CIC-EC, CIC 1426, 75010 Paris, France; Inserm, Pôle Recherche clinique, 75013 Paris, France.
authors: C
authors: C
authors: Lévy-Marchal
authors: Univ Paris Diderot, Sorbonne Paris Cité, ECEVE, UMRS 1123, 75010 Paris, France; Inserm, ECEVE U1123 et CIC-EC, CIC 1426, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France.
authors: C
authors: C
authors: Alberti
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D011788:Quality of Life; D019529:Sexuality / Q000502:physiology / Q000523:psychology; D012919:Social Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Education; Long-term outcomes; Pediatric type 1 diabetes; Quality of life; Sexuality; Social status