We interviewed overweight/obese, 12- to 18-year-old youth with T2DM, prediabetes, or insulin resistance and one parent from 5 US sites. Assessments included Pediatric Quality of Life Inventory (PedsQL), Health Utilities Index, family conflict, and diabetes burden.
In 108 adolescents, diagnoses included 40.7 % with T2DM, 25.0 % with prediabetes, and 34.3 % with insulin resistance. PedsQL summary score (SS) was higher in adolescents than parents (P = .02). Parents rated physical functioning lower than adolescents (P < .0001), but there were no differences in psychosocial health. Adolescent PedsQL SS did not differ with diagnosis, but was inversely associated with adolescent body mass index z-score (P = .0004) and family conflict (P < .0001) and associated with race/ethnicity (P < .0001). Number of adolescent co-morbidities (P = .007) and burden of diabetes care (P < .05) were inversely associated with parent PedsQL SS. There were no differences in the Health Utilities Index-Mark 3 multi-attribute utility score.
Parents perceive their adolescents¡¯ physical functioning as more impaired than adolescents themselves. Contextual factors including severity of obesity, race/ethnicity, family conflict, and burden of diabetes care influence health-related quality of life. Family-based approaches to treatment and prevention of T2DM may benefit from increased attention to the biopsychosocial context.