ODP608 Quality of Life and Treatment Satisfaction in Patients with Type 1 Diabetes Experiencing Different Models of Care in Saudi Arabia
Authors: Aldeeri Ibraheem , Al-Qahtani Khalid , Alshaibi Amal , Alshabib Norah , Alyusuf Ebtihal , Alguwaihes Abdullah , Al-Soﬁani Mohammed , Jammah Anwar 
Published: November 2022

Abstract

Background
Little is known about the model of care affecting quality of life(QoL)and treatment satisfaction among people with type 1 diabetes(PWT1D).

Objectives
To compare QoL, treatment satisfaction and cardiometabolic indices among PWT1D receiving different care models in Saudi Arabia.

Methods
QoL was measure using Audit of Diabetes Dependent Quality of Life(ADDQoL) and treatment satisfaction was measure using Diabetes Treatment Satisfaction Questionnaire status version(DTSQs). Out of 177 respondents to internet validated Arabic versions of ADDQoL and DTSQs,105 are receiving care at specialized diabetes clinics(SDC), whereas 72 are receiving traditional care at general endocrine clinics(GEC). In SDC,where care is delivered jointly by an interdisciplinary team,PWT1D are evaluated from their first visit simultaneously and thereafter as recommended by 6 care providers: diabetes specialist,educator,podiatrist,nutritionist,optometrist, and mental health specialist, while in GEC, PWT1D will be followed every 6-12months and referred to other services as needed where referrals require a long waiting period. ADDQoL and DTSQs scores,sociodemographic characteristics, and cardiometabolic indices were compared between the two groups. The association between patients’ characteristics and their ADDQoL and DTSQs scores were examined.

Results
Among the respondents,109(61.6%)females,132(74.6%)never married,136(76.8%) belongs to age group(18-30)years old, with a mean duration of diabetes(11.4±7.5years). Both groups are comparable across nearly all sociodemographic characteristics except for half of the SDC attendees reported higher income categories(≥10000 Saudi Riyals)(51.4%vs. 23.6%,p&lt;0. 001). Compared to participants in GEC, larger proportion of participants in SDC use insulin pump(29% vs. 0%, p&lt;0. 0001),continuous glucose monitoring(CGM)(73.3%vs. 13.9%, p&lt;0. 0001),have higher body mass index(26.3±6.4 kg/m2vs. 24.1±5.1 kg/m2,p=0. 016),and lower HbA1c(8.3±1.6%vs. 9.3±2.4%, p=0. 004). Receiving care in SDC is associated with higher DTSQs score(30.5±5.1vs. 26.2±7.9, p&lt;0. 0001),lower level of negative impact of diabetes on ADDQoL score(-2.2±1.9vs. -3.5±2.4, p&lt;0. 0001). Irrespective of clinic type, using insulin pump and CGM is associated with both higher DTSQs score(insulin pump(32±3.9)vs. MDI(28.5±7), p=0. 029), CGM(30.5±5.5)vs. glucometer(27.9±7.1), or not monitoring (22. 0±9.2), p&lt;0. 0001), and lower negative impact of diabetes on ADDQoL score(insulin pump(-1.3±1.1)vs. MDI(-2.9±2.3), p=0. 002),(CGM (-2.3±2.1)vs. glucometer(-3.1±2.4),or not monitoring(-3.5±2.2), p=0. 036). Another factor associated with a higher DTSQs score is: (being never married (29.3±6.5), or married(28.7±7)vs. divorced/widow(20.6±4.7), p=0. 018), whereas other factors associated with lower level of negative impact of diabetes on ADDQoL score are: (younger age(18-30years(-2.5±2.2),or 31-40years(-3.1±2. 0)vs. &gt;40years(-4.4±2.8), p=0. 013)),(being never married(-2.5±2.1)vs. married(-3.4±2.3),or divorced/window(-4.7±3.3), p=0. 010),(having bachelor degree or more (-2.4±1.9) vs. less than bachelor degrees (secondary school(-3.2±2.7),primary school(-3.9± 4.8),intermediate school(-5. 0±2.4), p=0. 005),and(being student(-2.2±1.9)vs. employed(-3.2±2.4), or unemployed(-3.2±2.5), p=0. 010).

Conclusion
QoL, treatment satisfaction and glycemic control among PWT1D can be enhanced by providing structured care and using devices(insulin pump and CGM). This necessitates a call for healthcare policymakers to utilize the existing health resources to optimize care for PWT1D.
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