Abstract
BACKGROUND: Type 1 diabetes mellitus is a lifelong condition with consequences that extend well beyond glycaemic control, often impacting individuals' socioeconomic status and overall quality of life. In Italy, the broader effects of early-onset type 1 diabetes on social and health-related outcomes have been insufficiently investigated. Therefore, this study aimed to investigate the socioeconomic impacts of type 1 diabetes among adults diagnosed with the condition before age 18. METHODS: Using data from the Italian Behavioral Risk Factor Surveillance System (PASSI) collected between 2011 and 2018 and in 2023, we analyzed key outcomes in adults aged 18-50 who were diagnosed with type 1 diabetes before age 18 and were on insulin therapy. Each case was matched by age and sex to two non-diabetic controls. Descriptive statistics and multivariable logistic regression were used to compare key indicators. RESULTS: Our sample included 993 participants (331 cases and 662 controls). Cases had significantly higher odds of being unemployed [OR = 1.57 (1.20-2.07)], experiencing severe financial difficulties [OR = 1.81 (1.05-3.13)], and reporting poor self-rated health [OR = 6.64 (2.53-17.43)]. Cases also had an increased likelihood of reporting physical impairment for 1-13 days [OR = 1.91 (1.30-2.81)] and ≥14 days [OR = 2.95 (1.54-5.65)], mental health impairment for 1-13 days [OR = 2.16 (1.46-3.19)], and daily activity limitations for 1-13 days [OR = 1.73 (1.06-2.82)]. CONCLUSIONS: These findings highlight the multifaceted burden of type 1 diabetes and the need for integrated approaches to care that address not only clinical but also socioeconomic and psychosocial dimensions of the disease.