Psychosocial and Spiritual Dimensions of Quality of Life in Children and Adolescents with Type 1 Diabetes: A Systematic Review

Abstract

Context: Type 1 diabetes (T1D) is a chronic metabolic disorder that commonly manifests in childhood or adolescence and requires ongoing medical supervision and daily self-management. The chronic nature of T1D, together with the complexities of its care, can affect not only physical well-being but also emotional health, social interactions, academic participation, and overall adjustment during critical developmental periods. This systematic review aimed to comprehensively examine how type 1 diabetes affects quality of life among pediatric and adolescent populations. Evidence Acquisition: From an initial set of 2645 articles published between January 2010 and August 2025, 16 studies met the predefined inclusion criteria. These studies examined the use of AI-based digital tools for diabetes self-management in children. A systematic search was conducted in PubMed, Scopus, Web of Science, CINAHL, PsycINFO, Embase, and SID using predefined keywords. Two independent reviewers performed screening and data extraction. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Tool, the Newcastle-Ottawa Scale, and the CASP checklist. Qualitative and quantitative findings were integrated using thematic analysis. Results: The findings indicate that living with type 1 diabetes during childhood or adolescence is frequently associated with reduced quality of life across multiple dimensions. Poor glycemic control, psychological burden related to ongoing disease management, and restrictions on academic and social activities were consistently associated with worse outcomes. Conversely, strong family involvement, structured self-management education, and access to psychosocial support services were repeatedly identified as factors contributing to improved well-being.