Effect of diabetes self-management education on health related quality of life of Tunisian children with type1 diabetes mellitus and their parents: A randomized controlled trial


Imen Ben Abdesselem
Raoudha Kebaili
Khansa Derbel
Hichem Ben Said
Lamia Boughammoura
Sonia Rouatbi
Jihene Bouguila


Aim : To assess the effect of diabetes self-management education (DSME) on health related quality of life (HRQoL) of Tunisian children/adolescents with type 1 diabetes mellitus and their parents.

Methods : This monocentral study used a randomized controlled trial design, during five-month intervention and five-month follow-up and including 110 patients (54 in the DSME intervention group and 56 in the Individual Education by Pediatrician (IEP) control group) and their parents. Pediatric Generic Core Quality-of-Life Inventory 4.0-Scale (PedsQL4.0) evaluated HRQoL.

Results : At baseline, both groups had similar clinical features and PedsQL4.0 scores (p>0.05). In DSME, clinical outcomes were significantly improved from baseline to follow-up (p<0.001), while in the IEP group, which received no intervention, these outcomes remained unchanged.  During follow-up, DSME showed higher PedsQL4.0 scores in parents’ proxy-report and children/adolescents self-report (p<0.001). According to parents’ proxy-report, PedsQL4.0 scores were significantly higher during follow-up compared to baseline in DSME (p<0.001) while they remained the same in IEP (p>0.05). DSME had higher percentage of change in the PedsQL4.0 scores than IEP (p<0.01). The median change varied from -5.01% to 0% vs 5.41% to 36.36% in IEP and DSME, respectively.

Conclusion : Encouraging healthcare professionals to incorporate these interventions could enhance the HRQoL of diabetic children and bolster their self-esteem.


Type 1 diabetes mellitus, child, Health related quality of life , Diabetes self-management intervention



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