{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T02:42:08Z","timestamp":1780368128532,"version":"3.54.1"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004035","name":"Jordan University of Science and Technology","doi-asserted-by":"publisher","award":["20230297"],"award-info":[{"award-number":["20230297"]}],"id":[{"id":"10.13039\/501100004035","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>The global prevalence of type 1 diabetes mellitus (T1DM) is increasing. Poor glycemic control in children and adolescents leads to both acute and chronic problems, reduced Health Related Quality of Life (HRQoL), and higher healthcare utilization. This study aimed to assess patient-reported outcomes related to self-management adherence, QoL, diabetes-related stigma, glycemic control, and other clinical outcomes along with their determinants, in insulin-treated pediatric T1DM patients in Jordan. A cross-sectional study was conducted from April to October 2023 at two health centers in Northern Jordan. Eligible pediatric T1DM patients attending outpatient clinics were enrolled. Trained pharmacists conducted face-to-face interviews with both children and their guardians, using validated tools that were translated into Arabic. Adherence was evaluated using the Diabetes Management Questionnaire, HRQoL was measured using the Pediatric Quality of Life Inventory 3.0 Diabetes Module, stigma was assessed using the Child Attitude Toward Illness Scale and glycemic control was determined by glycated hemoglobin levels. A total of 150 patients participated in the study. The mean adherence score was 57.4\u2009\u00b1\u200918.13. Factors such as younger age (P-value\u2009=\u20090.01), higher monthly income (P-value\u2009=\u20090.022) and shorter disease duration (P-value\u2009=\u20090.008) were associated with improved adherence. The mean pediatric QoL score was 63.27\u2009\u00b1\u200911.86, with male gender (P-value\u2009=\u20090.021) and the absence of disease-related factors (P-value\u2009=\u20090.004) linked to lower QoL scores. Additionally, body mass index (P-value\u2009=\u20090.041) and a family history of DM (P-value\u2009=\u20090.047) were linked to stigma. Most patients (76%) had uncontrolled diabetes, with disease duration (P-value\u2009=\u20090.019) and maternal educational level (P-value\u2009=\u20090.013) influencing glycemic control. These findings highlight that, despite widespread poor glycemic control, insulin adherence and QoL among pediatric T1DM patients in Jordan are above average. Targeted interventions are recommended to improve adherence and, in turn, overall patient outcomes.<\/jats:p>","DOI":"10.1371\/journal.pone.0322882","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T17:25:48Z","timestamp":1746465948000},"page":"e0322882","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Type 1 diabetes mellitus in children: Patient reported outcomes"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2229-5837","authenticated-orcid":true,"given":"Basima A.","family":"Almomani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roa\u2019a N.","family":"Elayyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samah F.","family":"Al-Shatnawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"key":"pone.0322882.ref001","author":"World Health Organization (WHO)","year":"2022"},{"key":"pone.0322882.ref002","year":"2021"},{"key":"pone.0322882.ref003","author":"International Diabetetes Federation (IDF)","year":"2021"},{"issue":"8","key":"pone.0322882.ref004","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1111\/pedi.13454","article-title":"ISPAD Clinical Practice Consensus Guidelines 2022: Definition, epidemiology, and classification of diabetes in children and adolescents","volume":"23","author":"I Libman","year":"2022","journal-title":"Pediatr Diabetes"},{"key":"pone.0322882.ref005","author":"International Diabetes Federation (IDF)","year":"2021"},{"key":"pone.0322882.ref006","doi-asserted-by":"crossref","first-page":"659","DOI":"10.2147\/DMSO.S350168","article-title":"Adherence to Diabetes Self-Management and Its Associated Factors Among Adolescents Living with Type 1 Diabetes at Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study","volume":"15","author":"Y Geneti","year":"2022","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"3","key":"pone.0322882.ref007","doi-asserted-by":"crossref","DOI":"10.5812\/compreped-134561","article-title":"Quality of Life, Medication Adherence, and Glycemic Control in Type 1 Diabetes Mellitus Children with Basal Bolus Regimen During COVID-19 in Limited Resources Setting","volume":"14","author":"N Rochmah","year":"2023","journal-title":"J Compr Ped"},{"issue":"6","key":"pone.0322882.ref008","first-page":"e40766","article-title":"Quality of Life Among Children With Type 1 Diabetes Mellitus in Alahsa: A Cross-Sectional Study","volume":"15","author":"JA Alhaddad","year":"2023","journal-title":"Cureus"},{"issue":"1","key":"pone.0322882.ref009","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.pcd.2022.12.006","article-title":"Association between early glycemic management and diabetes complications in type 1 diabetes mellitus: A retrospective cohort study","volume":"17","author":"J Suh","year":"2023","journal-title":"Prim Care Diabetes"},{"issue":"1","key":"pone.0322882.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/07435800.2019.1624567","article-title":"Factors Associated with Acute Complications among Individuals with Type 1 Diabetes in China: The 3C Study","volume":"45","author":"W Liu","year":"2020","journal-title":"Endocr Res"},{"issue":"1","key":"pone.0322882.ref011","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s13052-020-00930-4","article-title":"Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east Gojjam zone referral hospitals, northern Ethiopia, 2019","volume":"46","author":"B Assefa","year":"2020","journal-title":"Ital J Pediatr"},{"key":"pone.0322882.ref012","volume-title":"Health Related Stigma and Self-Adherence to Treatment among Adolescents with Type 1 Diabetes in the West Bank","author":"HNM Yaghi","year":"2023"},{"key":"pone.0322882.ref013","unstructured":"Mulungi-Bibangambah EN, Mworozi EA, Nyangabyaki C, Katahoire AR. 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