Preferences for type 2 diabetes health states among adolescents with or at risk of type 2 diabetes mellitus
Corresponding Author
Erinn T Rhodes
Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA
Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Erinn T. Rhodes, MD, MPH, Division of Endocrinology, Children's Hospital Boston, 333 Longwood Ave. 6th Floor, Boston, MA 02115, USA.Tel: (617) 355-3209;fax: (617) 730-0194;e-mail: [email protected]Search for more papers by this authorLisa A Prosser
Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, MI, USA
Center for Child Health Care Studies, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorTracy A Lieu
Center for Child Health Care Studies, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
Division of General Pediatrics, Children's Hospital Boston, Boston, MA, USA
Search for more papers by this authorThomas J Songer
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
Search for more papers by this authorDavid S Ludwig
Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA
Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Search for more papers by this authorLori M Laffel
Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA
Search for more papers by this authorCorresponding Author
Erinn T Rhodes
Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA
Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Erinn T. Rhodes, MD, MPH, Division of Endocrinology, Children's Hospital Boston, 333 Longwood Ave. 6th Floor, Boston, MA 02115, USA.Tel: (617) 355-3209;fax: (617) 730-0194;e-mail: [email protected]Search for more papers by this authorLisa A Prosser
Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, MI, USA
Center for Child Health Care Studies, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
Search for more papers by this authorTracy A Lieu
Center for Child Health Care Studies, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
Division of General Pediatrics, Children's Hospital Boston, Boston, MA, USA
Search for more papers by this authorThomas J Songer
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
Search for more papers by this authorDavid S Ludwig
Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA
Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Search for more papers by this authorLori M Laffel
Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA
Search for more papers by this authorAbstract
Rhodes ET, Prosser LA, Lieu TA, Songer TJ, Ludwig DS, Laffel LM. Preferences for type 2 diabetes health states among adolescents with or at risk of type 2 diabetes mellitus.
Objective: We evaluated how adolescents with or at risk of type 2 diabetes (T2DM) and their parent/guardians (parents) value health states associated with T2DM.
Methods: We interviewed overweight/obese [Body Mass Index (BMI) ≥ 85th percentile], 12–18-yr old adolescents with T2DM, prediabetes, or insulin resistance (IR) and a parent. The standard gamble (SG) method elicited preferences (utilities) for seven 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).
Results: There were 70 adolescents and 69 parents. Adolescents were 67.1% female and 15.5 ± 2.2 yr 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 yr 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' assessments of their current health with the SG and HUI were not correlated.
Conclusions: 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.
Supporting Information
Supporting Information
Additional Supporting Information may be found in the online version of this article:
Appendix S1. Type 2 Diabetes Health Values Study: Example Interview Guide
| Filename | Description |
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| PEDI_772_sm_AppendixS1.pdf129.6 KB | Supporting info item |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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