Preferences for Type 2 Diabetes Health States among Adolescents With or at Risk of Type 2 Diabetes Mellitus
Published Date:Apr 13 2011
Source:Pediatr Diabetes. 12(8):724-732.
Attitude To Health
Diabetes Mellitus, Type 2
Kidney Failure, Chronic
Quality Of Life
Type 2 Diabetes
Pubmed Central ID:PMC4793716
Funding:K01 DP000089/DP/NCCDPHP CDC HHS/United States
K01DP000089/DP/NCCDPHP CDC HHS/United States
K24DK082730/DK/NIDDK NIH HHS/United States
We evaluated how adolescents with or at risk of type 2 diabetes (T2DM) and their parent/guardians (parents) value health states associated with T2DM.
We interviewed overweight/obese (BMI≥85th percentile), 12–18 year-old adolescents with T2DM, prediabetes, or insulin resistance (IR) and a parent. The standard gamble (SG) method elicited preferences (utilities) for 7 hypothetical T2DM health states reported on a scale from 0 (dead) to 1 (perfect health). Adolescent’s current health was evaluated with the SG and Health Utilities Index (HUI).
There were 70 adolescents and 69 parents. Adolescents were 67.1% female and 15.5±2.2 years old; 30% had T2DM, 30% prediabetes, and 40% IR. Almost half (48.6%) had a BMI>99th percentile. Parents (83% mothers) were 45.1±7.3 years old and 75% had at least some college/technical school education. Adolescents and parents rated T2DM with no complications treated with diet as most desirable (median [IQR]; adolescent 0.72 [0.54, 0.98]; parent 1.0 [0.88, 1.0]) and end stage renal disease as least desirable (adolescent 0.51 [0.31, 0.70]; parent 0.80 [0.65, 0.94]). However, adolescents’ utilities were significantly lower (p≤0.001) than parents for all health states assessed. Adolescents’ assessment of their current health with the SG and HUI were not correlated.
Adolescents with or at risk of T2DM rated treatments and sequelae of diabetes as significantly worse than their parents. These adolescent utilities should be considered in the evaluation of treatment strategies for youth with T2DM. Family-based programs for T2DM must also be prepared to address conflicting preferences in order to promote shared-decision making.
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