Assessment of self-reported self-esteem in healthy and diabetic children and adolescents in Greece

Background: The aim of the present study was to evaluate any possible negative effect of diabetes on the self-esteem of children and adolescents with diabetes. Methods: Self-esteem was evaluated using the Culture-Free Self-Esteem Inventory (CFSEI-2) in 144 patients with Type 1 diabetes mellitus (T1DM; 7-18 years of age) treated in a diabetes center and compared against that of 136 healthy children and adolescents. Results: Self-esteem was correlated with age (P = 0.017), but not with diabetes (P = 0.886). The median CFSEI-2 score for both healthy and diabetic children was 22. There was no significant correlation between self-esteem and sex, body mass index (BMI), physical exercise, HbA1c or parental educational level. According to Spearman's rank correlation coefficient (r(s)), there was a significant association between age and self-esteem (r(s) = -0.15). Conversely, although BMI (r(s) = -0.09) and treatment duration (r(s) = -0.107) had a slight negative effect on self-esteem and the duration of physical exercise (r(s) = 0.11) and parental education (r(s) = 0.07) seemed to have a positive effect, the associations did not reach statistical significance. Conclusions: Self-esteem in diabetic children is mainly affected by their age, level of physical activity and level of family support. These findings emphasize the need to discriminate between glycemic control and diabetic adjustment.