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Abdel-Rahman N, Manor O, Elran E, Siscovick D, Calderon-Margalit R. Implications of Patient-Reported Outcome Measures among patients with recently diagnosed type 2 diabetes. Isr J Health Policy Res 2024; 13:6. [PMID: 38297393 PMCID: PMC10829200 DOI: 10.1186/s13584-024-00592-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 01/24/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND For the past two decades, the assessment of the quality of diabetes care has mostly relied on clinical quality indicators. These have not included Patient-Reported Outcome Measures (PROMs) which provide information on outcomes deemed valuable by patients. We aimed to examine the potential utility of PROMs in type 2 diabetes care and to study the association of PROMs with patients' characteristics and clinical quality indicators. METHODS A cross-sectional survey of recently (≤ 4 years) diagnosed patients with type 2 diabetes (n = 392) in the setting of a large health plan. PROMs were based on two well-validated questionnaires, the Problem Areas in Diabetes (PAID) one-page questionnaire that measures diabetes-related distress, and the ten item PROMIS-10 global health questionnaire that measures general health. Additional items were added following a previous qualitative study among Israeli patients with diabetes. The survey was carried out using phone interviews, and data collected were linked to the electronic medical records. Multivariable regression models were used to assess the associations of socio-demographic variables and clinical quality indicators with the PROMs. RESULTS About a fifth of participants (22%) had high diabetes-related distress (PAID score ≥ 40), a third reported that they did not feel confident in self-management of diabetes and about a third reported having sexual dysfunction. Women, younger patients, and those with a low education level (≤ 12 years) reported worse general health, were more likely to experience high diabetes-related distress, and to have low confidence in diabetes self-management. Interestingly, performance of all seven diabetes quality indicators was associated with worse general health and high diabetes-related distress. Of note, levels of glycated hemoglobin, LDL-cholesterol, or blood pressure were not associated with PROMs. CONCLUSIONS PROMs provide important information on patient self-reported health status and are likely to reflect aspects of the quality of care that are not otherwise available to clinicians. Thus, the use of PROMs has the potential to expand the evaluation of diabetes care and promote patient-centered care. We recommend that policy-makers in the Ministry of Health and health maintenance organizations implement PROMs for assessing and improving the care for patients with type 2 diabetes.
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Affiliation(s)
- Nura Abdel-Rahman
- Braun School of Public Health, The Hebrew University of Jerusalem Hadassah Medical School, 91120, Jerusalem, Israel.
| | - Orly Manor
- Braun School of Public Health, The Hebrew University of Jerusalem Hadassah Medical School, 91120, Jerusalem, Israel
| | - Einat Elran
- Maccabi Healthcare Services, Tel Aviv, Israel
| | | | - Ronit Calderon-Margalit
- Braun School of Public Health, The Hebrew University of Jerusalem Hadassah Medical School, 91120, Jerusalem, Israel
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AbuAlhommos AK, Alturaifi AH, Al-Bin Hamdhah AM, Al-Ramadhan HH, Al Ali ZA, Al Nasser HJ. The Health-Related Quality of Life of Patients with Type 2 Diabetes in Saudi Arabia. Patient Prefer Adherence 2022; 16:1233-1245. [PMID: 35586578 PMCID: PMC9109984 DOI: 10.2147/ppa.s353525] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Diabetes mellitus (DM) is one of the most common chronic diseases in the world. Diabetes mellitus has a major effect on patients' quality of life, especially when the patient has other comorbidities. Therefore, this study aims to assess the quality of life of type 2 diabetic patients in the Al-Ahsa region of Saudi Arabia. METHODS This was a cross-sectional study, which was conducted from September 2020 to May 2021 on patients with type 2 diabetes mellitus in the Al-Ahsa region of Saudi Arabia. Inclusion criteria were patients diagnosed with T2DM and aged 18 years and older. The EQ-5D-5L tool was used in this study to measure the quality of life. RESULTS A total of 321 patients with T2DM participated in the study. Only 8.4% of the study participants reported that their disease did not let them do their daily activities at all. The most commonly reported problems related to diabetes mellitus and its effect on patients' quality of life were pain/discomfort (around 68.0% of the patients reported some sort of problems in this dimension), followed by mobility, and depression and anxiety. There was a significant difference between males and females in terms of their quality of life, specifically self-care, pain and discomfort, and depression and anxiety (p<0.05). Patients from different marital statuses, education levels, employment status, and duration of the disease showed a significant difference in quality of life, except for depression and anxiety (p>0.05). CONCLUSION Pain/discomfort, mobility, and depression/anxiety are the main problems that are affecting diabetic patients' quality of life. Future studies are recommended to explore the effectiveness of patient tailored interventions to decrease the negative impact of these dimensions on patients' quality of life.
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Affiliation(s)
- Amal Khaleel AbuAlhommos
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
- Correspondence: Amal Khaleel AbuAlhommos, Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia, Tel +966596150032, Email
| | - Amjad Heji Alturaifi
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
| | | | - Hawra Hassan Al-Ramadhan
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
| | - Zahra Abdullah Al Ali
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
| | - Hawra Jumah Al Nasser
- Pharmacy Practice Department, Clinical Pharmacy College, King Faisal University, Alhasa, Saudi Arabia
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Meher D, Kar S. Effect of pandemic on Quality of life in Diabetics (QOLID) assessment: Data from a teaching hospital in Bhubaneswar, Odisha, India. J Family Med Prim Care 2021; 10:3780-3784. [PMID: 34934680 PMCID: PMC8653453 DOI: 10.4103/jfmpc.jfmpc_287_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Quality of life in Diabetics (QOLID) questionnaire is a validated tool to assess the quality of life affected by diagnosed diabetic patients and has 8 sub domains, which are essential factors that have proven effect on the management. In a state of art Diabetic clinic in Bhubaneswar city, the tool was used to add more quality to diabetic management. Methods: The ongoing assessment through the months of 2020 (study period being from December 2019 to August 2020), offered an opportunity to assess the effect of the pandemic on QOLID scores and review some nascent or strong factors which may be affecting chronic disease management. Results: Complete data could be collected from 599 subjects, 343 from pre pandemic and 256 from pandemic period. The overall scores which were on 100, did not show any significant difference for pre covid and the Covid period, interestingly nearly 1.93 points better in Covid period (69.69±11.10 vs71.62±8.49; p=0.396). Mild difference in overall scores of 4.82 points is seen in females in Covid period; and as seen in age group data maximum gain in sub domains, more for females is seen in the emotional and mental health. Though women reporting to the clinic in both periods are usually in 1:2 ratios, as against men; but QOLID scores in both men and women in Covid period was 71 to 80 points. After the univariate analysis for significant factors, it was that Covid (1.50; 1.08 - 2.07) ; compliance to medications (2.27; 1.48 - 3.50) and reporting of all diabetic complications especially that of eye and depression are coming out to be strong associative factors to affect QOLID scores. Interestingly, rising education has a protective effect on QOLID scores that was significant as higher awareness and better job or earning opportunities may be a contributor for higher QOLID scores for the well educated. Conclusion: This brings out a strong emphasis on QOL assessments to be made an inbuilt part of Diabetic management at all centers to maximize treatment outcomes
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Affiliation(s)
- Dayanidhi Meher
- Department of Endocrinology, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Patia, Bhubaneswar, Odisha, India
| | - Sonali Kar
- Department of Community Medicine, Kalinga Institute of Medical Sciences (KIMS), KIIT University, Patia, Bhubaneswar, Odisha, India
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Quality of Life Assessment in Diabetic Patients Using a Validated Tool in a Patient Population Visiting a Tertiary Care Center in Bhubaneswar, Odisha, India. ScientificWorldJournal 2021; 2020:7571838. [PMID: 33456400 PMCID: PMC7785381 DOI: 10.1155/2020/7571838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/11/2020] [Accepted: 12/16/2020] [Indexed: 11/25/2022] Open
Abstract
Odisha has 4.2 million diabetic patients against the country's 70 million with an urban prevalence of nearly 15.4%. Diabetes is affecting younger age groups, thus having a crucial impact on quality of life of the affected. A qualitative endeavour was attempted at the diabetic clinic of a tertiary care set up in the capital city of Bhubaneswar to create a diabetic surveillance data assembly, wherein subjects above 18 years of age and newly diagnosed or on follow-up, after obtaining informed consent, were made to respond to a quality of life (QOLID) validated tool. The pretested tool has 8-domain role limitation due to physical health, physical endurance, general health, treatment satisfaction, symptom botherness, financial worries, emotional/mental health, and diet advice tolerance. The validated tool had 34 items (questions) that were selected to represent these domains on the basis of extraction communality, factor loading, and interitem and item-total correlations. The final questionnaire had an overall Cronbach's alpha value of 0.894 (subscale: 0.55 to 0.85), showing high internal consistency in the current study population. A score for each domain was calculated by simple addition of items scores. Each individual domain score was then standardized by dividing by maximum possible domain score and multiplying by 100. All individual standardized domain scores were then added and divided by 8 (number of domain) to obtain an overall score. The data collection was done for 400 patients as an interim analysis. Univariate and subsequently multivariate analysis was performed to decide the predictors that affected quality of life. Age over 50 years (OR = 1.81, CI 1.12–2.93; p=0.014), female gender (OR = 2.05, CI 1.26–3.35; p=0.004), having foot complications (OR = 2.81, CI 1.73–4.55; p < 0.001), and having depression (OR = 1.88, CI 1.15–3.06, p=0.011) emerged as predictors of poor QOLID scores. The tool can be made a subtle part of chronic case management of diabetes to ensure patient's participation in the treatment of the disease and to create a database that can redefine diabetic care in India to suit the diverse regional settings in the country.
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Jackson IL, Onung SI, Oiwoh EP. Self-care activities, glycaemic control and health-related quality of life of patients with type 2 diabetes in a tertiary hospital in Nigeria. Diabetes Metab Syndr 2021; 15:137-143. [PMID: 33340873 DOI: 10.1016/j.dsx.2020.12.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/08/2020] [Accepted: 12/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Diabetes is one of the global health emergencies of the 21st century. This study sought to assess self-care behaviours, glycaemic control and health-related quality of life (HRQoL) of type 2 diabetes patients at a Nigerian hospital, determine factors associated with HRQoL, and assess the inter-relationship among these outcomes. METHODS The Summary of Diabetes Self-Care Activities (SDSCA) measure was used to assess self-care behaviours; HRQoL was assessed with the Appraisal of Diabetes Scale (ADS) and SF-12v2 Health Survey. Glycaemic control was assessed with fasting blood sugar (FBS). The questionnaires were distributed to 250 eligible patients attending Endocrinology clinic at the University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria. RESULTS Mean scores (±SD) of self-care behaviours were 4.0 ± 1.3, 3.9 ± 1.0, 2.4 ± 1.2, 1.0 ± 1.1, and 2.5 ± 2.1 for general diet, specific diet, exercise, blood glucose monitoring, and foot care respectively. Mean FBS was 7.1 ± 2.1 mmol/L. Mean ADS score was 18.1 ± 4.2. The physical and mental component summary scores were 47.84 ± 8.21 and 45.66 ± 8.74 respectively. HRQoL was significantly associated with patient socio-demographic (except gender) and clinical variables (p < 0.05). Self-care activities, FBS and HRQoL were significantly inter-correlated (rs -0.31 to 0.68; p < 0.01, p < 0.001). CONCLUSIONS Patients were more adherent to diet recommendations than to other aspects of self-care. Though most patients had adequate glucose control, the presence of diabetes had a negative impact on the mental component of health. HRQoL was affected by most of the patient-related variables. Interventions to improve adherence to self-care are recommended to achieve good glycaemic control and improve HRQoL.
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Affiliation(s)
- Idongesit L Jackson
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, P.M.B, 1017, Uyo, Akwa Ibom State, Nigeria.
| | - Samuel I Onung
- Department of Internal Medicine, Endocrine and Metabolism Unit, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Emmanuel P Oiwoh
- Department of Clinical Pharmacy and Biopharmacy, University of Uyo, Uyo, Akwa Ibom State, Nigeria
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Malliarou M, Desikou C, Lahana E, Kotrotsiou S, Paralikas T, Nikolentzos A, Kotrotsiou E, Sarafis P. Diabetic patient assessment of chronic illness care using PACIC. BMC Health Serv Res 2020; 20:543. [PMID: 32546232 PMCID: PMC7296774 DOI: 10.1186/s12913-020-05400-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 06/04/2020] [Indexed: 11/21/2022] Open
Abstract
Background The Patient Assessment of Chronic Illness Care plus is used in order to assess whether provided care is congruent with the Chronic Care Model, according to patients. The purpose of this study was to correlate PACIC+ and the revised 5As “ask, advise, agree, assist and arrange” scoring of a sample of DM patients, with their QoL, depressive symptomatology, demographic and disease characteristics, self-management behaviours of healthy eating and physical activity. Methods This is a cross-sectional study where data were collected between January and April 2018 by using three questionnaires (PACIC+, SF-36, CES-D) from a sample of 90 DM patients treated at a Public General Hospital of Central Greece. Anonymous self-completed questionnaires were used to collect the data. Data was processed in the Statistical Package for the Social Sciences (SPSS). Results The mean age of the participants with DM was 52.8 years (SD = 21.2 years), with cardiovascular disease and arterial hypertension scoring as the most frequently reporting chronic comorbidities. The healthcare received by DM patients has been correlated with their QoL. More specifically SF – 36 and PACIC+ scale scores showed a positive and low correlation in several subscales. The total score of PACIC+ scale as well as the Patient activation score were increased in higher scores of vitality (p = 0.034 & p = 0.028 respectively), hence both scores correlate significantly with latter. In addition, Delivery System / Practice Design score was increased in higher scores of mental health (p = 0.01) and MCS (p = 0.03). Conclusions The shift from hospital care focusing on the disease to a more patient-oriented approach puts forward a dynamic holistic approach to chronic diseases and the reduction of their impact. Finding evidence-based and effective strategies to promote health, prevent and manage chronic diseases such as diabetes mellitus is deemed to be crucial and necessary. PACIC+, which is a tool of a patient-level assessment of CCM implementation, can be used by countries which intend to apply changes in the way their health systems provide chronic care and specifically wish to improve the quality of chronic disease care and the QoL of their patients.
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Affiliation(s)
- Maria Malliarou
- Department of Nursing, University of Thessaly, Perifreiakh Odos Larisas, Trikalon, TK 41110, Larisa, Greece
| | - Christina Desikou
- General Public Hospital of Volos "Achillopouleio", Athanasaki 3, TK 38222, Volos, Greece
| | - Eleni Lahana
- University of Thessaly, Perifreiakh Odos Larisas, Trikalon, TK 41110, Larisa, Greece
| | - Styliani Kotrotsiou
- University of Thessaly, Perifreiakh Odos Larisas, Trikalon, TK 41110, Larisa, Greece
| | - Theodosios Paralikas
- University of Thessaly, Perifreiakh Odos Larisas, Trikalon, TK 41110, Larisa, Greece
| | | | - Evangelia Kotrotsiou
- University of Thessaly, Perifreiakh Odos Larisas, Trikalon, TK 41110, Larisa, Greece
| | - Pavlos Sarafis
- Department of Nursing, Cyprus University of Technology, 30 Archbishop Street, 3036, Limassol, Cyprus.
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Al-Taie N, Maftei D, Kautzky-Willer A, Krebs M, Stingl H. Assessing the quality of life among patients with diabetes in Austria and the correlation between glycemic control and the quality of life. Prim Care Diabetes 2020; 14:133-138. [PMID: 31859064 DOI: 10.1016/j.pcd.2019.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/02/2019] [Accepted: 11/05/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Quality of life is becoming an important health outcome and among the main goals of every healthcare intervention. This study aims to assess the reliability of the German version of the World Health Organization Quality of Life-BREF instrument (WHOQOL-BREF) among Austrian patients with diabetes and examine the correlation to glycated hemoglobin (HbA1c). METHODS This was a cross-section study that involved 223 patients with diabetes who attended the diabetes center at Melk Hospital in Austria. The German version of the WHOQOL-BREF questionnaire was used to assess their quality of life from 2018 to 2019. The response to each question was scored from 1 to 5 (ranged from strongly disagree to strongly agree) on the Likert scale. The reliability of the WHOQOL-BREF instrument was assessed using the Cronbach's α, and the Spearman correlation coefficient was used to examine the correlation between the quality of life and the HbA1c. RESULTS There were 208 valid WHOQOL-BREF questionnaires with a response rate of 93.7%. The overall observed Cronbach's α for WHOQOL-BREF was 0.86. The mean±standard deviation (SD) for the physical domain, psychological domain, social domain, and environmental domain were 61.9±19.1, 71.5±17.8, 71.0±19.6, and 81.3±11.1, respectively. There was a moderate but statistically significant negative correlation between HbA1c and the physical health domain (rs=-0.31, p<0001). There was also a weak correlation between the HbA1c and other domains: psychological (rs=-0.23, p<001), social relationships (rs=-0.15, p<005) and environmental (rs=-0.23, p<001). CONCLUSION This study showed that the German form of the WHOQOL-BREF is a valid instrument to evaluate the quality of life among Austrian patients with diabetes. There was a moderate to weak negative association between WHOQOL-BREF and HbA1c.
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Affiliation(s)
- Nawras Al-Taie
- Center for Diabetes and Metabolic Diseases, Department of Internal Medicine, Melk, Austria.
| | - Delia Maftei
- Center for Diabetes and Metabolic Diseases, Department of Internal Medicine, Melk, Austria
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michael Krebs
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Harald Stingl
- Center for Diabetes and Metabolic Diseases, Department of Internal Medicine, Melk, Austria
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Svedbo Engström M, Leksell J, Johansson UB, Borg S, Palaszewski B, Franzén S, Gudbjörnsdottir S, Eeg-Olofsson K. Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes - a nationwide cross-sectional study. Health Qual Life Outcomes 2019; 17:141. [PMID: 31412881 PMCID: PMC6694672 DOI: 10.1186/s12955-019-1212-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/07/2019] [Indexed: 01/04/2023] Open
Abstract
Background Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting. Methods In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18–80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36-item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes. Results Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures. Conclusions Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition. Electronic supplementary material The online version of this article (10.1186/s12955-019-1212-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Svedbo Engström
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, SE-405 30, Gothenburg, Sweden. .,School of Education, Health and Social Studies, Dalarna University, SE-791 88, Falun, Sweden.
| | - Janeth Leksell
- School of Education, Health and Social Studies, Dalarna University, SE-791 88, Falun, Sweden.,Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, SE-751 85, Uppsala, Sweden
| | - Unn-Britt Johansson
- Sophiahemmet University, SE-114 86, Stockholm, Sweden.,Department of Clinical Sciences and Education, Karolinska Institutet, Södersjukhuset, SE-118 83, Stockholm, Sweden
| | - Sixten Borg
- Department of Clinical Sciences in Malmö, Health Economics Unit, Lund University, Medicon Village, SE-223 81, Lund, Sweden
| | - Bo Palaszewski
- Department of Data Management and Analysis, Region Västra Götaland, Gothenburg, Sweden
| | - Stefan Franzén
- , Register Center Västra Götaland, SE-413 45, Gothenburg, Sweden
| | - Soffia Gudbjörnsdottir
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, SE-405 30, Gothenburg, Sweden.,, Register Center Västra Götaland, SE-413 45, Gothenburg, Sweden
| | - Katarina Eeg-Olofsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, SE-405 30, Gothenburg, Sweden.,Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden
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Rwegerera GM, Moshomo T, Gaenamong M, Oyewo TA, Gollakota S, Rivera YP, Masaka A, Godman B, Shimwela M, Habte D. Health-related quality of life and associated factors among patients with diabetes mellitus in Botswana. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2017.05.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Godfrey Mutashambara Rwegerera
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, BotswanaFaculty of Medicine, Department of Internal Medicine, University of Botswana, Botswana
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Thato Moshomo
- Scottish Livingstone Hospital, Molepolole, BotswanaScottish Livingstone Hospital, Molepolole, Botswana
| | - Marea Gaenamong
- Department of Accident and Emergency, Princess Marina Hospital, Gaborone, BotswanaDepartment of Accident and Emergency, Princess Marina Hospital, Gaborone, Botswana
| | - Taibat Aderonke Oyewo
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Sivasomnath Gollakota
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Yordanka Piña Rivera
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, BotswanaFaculty of Medicine, Department of Internal Medicine, University of Botswana, Botswana
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Anthony Masaka
- Botho University, Gaborone, BotswanaBotho University, Gaborone, Botswana
| | - Brian Godman
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, SwedenDepartment of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United KingdomStrathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Meshack Shimwela
- Amana Municipal Hospital, Dar-es-Salaam, TanzaniaAmana Municipal Hospital, Dar-es-Salaam, Tanzania
| | - Dereje Habte
- Management Sciences for Health (MSH), Addis Ababa, EthiopiaManagement Sciences for Health (MSH), Addis Ababa, Ethiopia
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Evaluating the Direct and Indirect Effects of SF-36 Domains Score on Two Main Factors in Diabetic Patients with Path Analysis: Health-Related Quality of Life Study. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2019. [DOI: 10.2478/rjdnmd-2019-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background and aims: Diabetes mellitus (DM) patients have a lower quality of life. This study aimed to examine the direct and indirect effect of eight domains score of the SF-36 questionnaire on two main factors, i.e., overall physical health (GH_M) and overall mental health (MH_M), in DM patients. To the best of our knowledge, this issue has been rarely studied so far.
Material and method: A total of 1037 DM patients filled out the Persian version of the SF-36 questionnaire. The path analysis was used in this study.
Results: In this research, only social functioning (SF) domain has significantly lower the men compared to women (P=0.06). Physical functioning (PF), bodily pain (BP), general health (GH) and vitality (VT) have a negative significant direct effect on the GH_M factor. GH domain also has a positive indirect and total effect on MH_M factor, and other domains have no significant total effect on MH_M factor.
Conclusion: It is better that physicians, focus on regulating physical activity and reducing body pain in diabetes patients, which have the most direct impact on HRQoL, to achieve a more effective outcome in improving quality of life in this patient.
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Qin W, Blanchette JE, Murrock C. Exploring the Relationship Between Lifestyle Behaviors and Health-Related Quality of Life Among Older Adults With Diabetes. THE DIABETES EDUCATOR 2019; 45:96-104. [PMID: 30803371 DOI: 10.1177/0145721718816630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose The purpose of the study was to examine the association between 3 lifestyle behaviors (smoking, physical activity, and fruit and vegetable consumption) and health-related quality of life (HRQOL) among older adults diagnosed with diabetes. Methods A sample of the US population 65 years and older who were diagnosed with diabetes from the 2015 Behavioral Risk factor Surveillance System (N = 11 503) was analyzed. The 4 HRQOL measures were self-rated health, physically unhealthy days, mentally unhealthy days, and impaired activity days in the past month. Multiple logistic regression analysis was conducted to predict HRQOL. Results The multiple logistic regression results showed that smoking and lack of physical activity were significant predictors for higher odds of fair or poor self-rated health, more physically unhealthy days, more mentally unhealthy days, and more impaired activity days during past 30 days. No significant relationship was found between fruit and vegetable consumption and any HRQOL measure. Conclusions Findings imply that diabetes education could continue and enhance efforts in smoking cessation and increase physical activity to promote the HRQOL among older adults diagnosed with diabetes. In addition, the measure of fruit and vegetable consumption should be further studied to reflect the needs of older adults with diabetes.
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Affiliation(s)
- Weidi Qin
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, Ohio
| | - Julia E Blanchette
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio.,Cleveland Clinic Foundation, Cleveland, Ohio
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Lo C, Zimbudzi E, Teede HJ, Kerr PG, Ranasinha S, Cass A, Fulcher G, Gallagher M, Polkinghorne KR, Russell G, Usherwood T, Walker R, Zoungas S. Patient-reported barriers and outcomes associated with poor glycaemic and blood pressure control in co-morbid diabetes and chronic kidney disease. J Diabetes Complications 2019; 33:63-68. [PMID: 30621853 DOI: 10.1016/j.jdiacomp.2018.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/18/2018] [Accepted: 09/26/2018] [Indexed: 12/21/2022]
Abstract
AIMS In patients with comorbid diabetes and chronic kidney disease, the extent to which patient-reported barriers to health-care and patient reported outcomes influence the quality of health care is not well established. This study explored the association between patient-reported barriers to health-care, patient activation, quality of life and diabetes self-care, with attainment of glycaemic and blood pressure (BP) targets. METHODS This cross-sectional study recruited adults with diabetes and CKD (eGFR 20 to <60 ml/min/1.73m2) across four hospitals. We combined clinical data with results from a questionnaire comprising measures of patient-identified barriers to care, the Patient Activation Measure (PAM), 12-Item Short Form Survey (SF-12), and the Summary of Diabetes Self-Care Activity (SDSCA). RESULTS 199 patients, mean age 68.7 (SD 9.6), 70.4% male and 90.0% with type 2 diabetes were studied. Poor glycaemic control was associated with increased odds of patient reported "poor family support" (OR 4.90; 95% CI 1.80 to 13.32, p < 0.002). Poor BP control was associated with increased odds of patient reported, "not having a good primary care physician" (OR 6.01; 2.42 to 14.95, p < 0.001). The number of barriers was not associated with increased odds of poor control (all p > 0.05). CONCLUSIONS Specific patient-reported barriers, lack of patient perceived family and primary care physician support, are associated with increased odds of poor glycaemic and blood pressure control respectively. Interventions addressing these barriers may improve treatment target attainment.
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Affiliation(s)
- Clement Lo
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Diabetes and Vascular Medicine Unit, Monash Health, VIC, Australia
| | - Edward Zimbudzi
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Department of Nephrology, Monash Health, VIC, Australia
| | - Helena J Teede
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Diabetes and Vascular Medicine Unit, Monash Health, VIC, Australia
| | - Peter G Kerr
- Department of Nephrology, Monash Health, VIC, Australia
| | - Sanjeeva Ranasinha
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Alan Cass
- Menzies School of Health Research, Casuarina, NT, Australia; The George Institute for Global Health, NSW, Australia
| | - Gregory Fulcher
- Department of Diabetes and Endocrinology, Royal North Shore Hospital, NSW, Australia
| | - Martin Gallagher
- The George Institute for Global Health, NSW, Australia; Department of Nephrology, Concord Hospital, NSW, Australia
| | - Kevan R Polkinghorne
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Department of Nephrology, Monash Health, VIC, Australia
| | - Grant Russell
- Department of General Practice, School of Primary and Allied Health Care, Monash University, VIC, Australia
| | - Tim Usherwood
- The George Institute for Global Health, NSW, Australia; Department of General Practice, Sydney Medical School Westmead, NSW, Australia
| | - Rowan Walker
- Department of Renal Medicine, Alfred Health, VIC, Australia
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Diabetes and Vascular Medicine Unit, Monash Health, VIC, Australia; The George Institute for Global Health, NSW, Australia.
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Albasheer OB. The Impact of Depressive Symptoms on the Quality of Life of Patients with Type 2 Diabetes in Jazan Region, KSA. Curr Diabetes Rev 2019; 15:288-293. [PMID: 30277161 DOI: 10.2174/1573399814666181002100223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/07/2018] [Accepted: 09/25/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The purpose of this study is to determine the impact of depressive symptoms on the quality of life of type 2 diabetic patients (T2DM). METHODS A cross-sectional study of 332 T2DM patients aged ≥18 years living in Jazan region of Saudi Arabia was conducted. Validated questionnaire was used for demographic and disease characteristics. Depressive symptoms of the participants were assessed using the Patient Health Questionnaire (PHQ-9). The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) was utilized to assess the degree of life enjoyment and satisfaction. RESULTS Depressive symptoms were observed in 34.7% (112) of the total participants. The overall sense of wellbeing (mean 3.23, P. value 0.000), physical (mean 3.37, P. value 0.003), psychosocial (mean 2.99 P. value 0.000) and social domains (mean 3.53, P. value 0.000) of quality of life were significantly reduced in T2DM patients with depressive symptoms. CONCLUSION The impact of depressive symptoms on quality of life of T2DM patients was more significant than the impact of diabetes alone. Symptoms of depression reduce the individual coping and hence reduce functioning. This study emphasizes the vital importance of an integrated holistic approach that addresses both the practical and emotional issues in diabetes care.
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Affiliation(s)
- Osama B Albasheer
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Jing X, Chen J, Dong Y, Han D, Zhao H, Wang X, Gao F, Li C, Cui Z, Liu Y, Ma J. Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis. Health Qual Life Outcomes 2018; 16:189. [PMID: 30231882 PMCID: PMC6147036 DOI: 10.1186/s12955-018-1021-9] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 09/13/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Diabetes is a chronic disease, and it could affect both health and quality of life (QOL). A lot of studies have reported some predictors of QOL of type 2 diabetes patients. While their results were not completely consistent. So the aim of our study was finding out the related factors (including characteristics related to the disease, life styles and mental health factors) of QOL of type 2 diabetes patients. METHODS We searched Cochrane library, EmBase, PubMed and CNKI databases for published studies that evaluated the related factors of QOL of type 2 diabetes patients by using a proper statistic method and had effect sizes (OR or β) and 95% confidence intervals from January 1st 2000 to May 31st 2016. Any study types were acceptable, and we excluded the reviews, letters, editorials and pooled analyses. The data were analyzed using STATA software (Version 12.0; Stata Corporation). Effect sizes and 95% confidence intervals were calculated to evaluate the relationship between these factors and QOL. RESULTS Eighteen studies were included into our systematic review and meta-analysis, totaling 57,109 type 2 diabetes patients. Do more physical exercises (The pooled ORs ranged from 0.635 to 0.825 for different scales, less than 1.00), glucose check more frequently [pooled OR (95%CI): 0.175 (0.041, 0.756)] were associated with a better QOL. Presence of complications (The pooled ORs ranged from 1.462 to 3.038 for different scales, more than 1.00), presence of hypertension [pooled OR (95%CI): 1.389 (1.173, 1644)], longer duration of diabetes [pooled OR (95%CI): 1.865 (1.088, 3.197)], diet with more red meat [pooled OR (95%CI): 2.085 (1.063, 4.089)] and depression (The pooled ORs ranged from 3.003 to 11.473 for different scales, higher than 1.00) were associated with a worse QOL. CONCLUSION The results of this study show that physical exercise, glucose check frequently, complications, hypertension, duration of diabetes, diet with more red meat, and depression were associated with the QOL of type 2 diabetes patients.
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Affiliation(s)
- Xiyue Jing
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Jiageng Chen
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Yanan Dong
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Duolan Han
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Haozuo Zhao
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Xuying Wang
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Fei Gao
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Changping Li
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Zhuang Cui
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Yuanyuan Liu
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
| | - Jun Ma
- Department of Health Statistics, College of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 People’s Republic of China
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Assari S, Lankarani MM, Piette JD, Aikens JE. Self-Rated Health and Glycemic Control in Type 2 Diabetes: Race by Gender Differences. J Racial Ethn Health Disparities 2018; 5:721-727. [PMID: 28779480 PMCID: PMC6378221 DOI: 10.1007/s40615-017-0416-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although some studies have shown a link between self-rated health (SRH) and glycemic control in type 2 diabetes (DM), other studies have failed to support this association. The purpose of this study was to determine whether these equivocal findings can be explained by specific interactions between gender, race, and SRH, as suggested by the intersectionality literature. METHODS This cross-sectional study included 287 patients with DM (85 Black men, 78 Black women, 64 White men, and 60 White women). After adjusting for demographic and medical factors, we regressed HbA1c on SRH with and without interactions between gender, race, and SRH. We conducted additional subgroup analyses to further characterize gender by race group differences. RESULTS Although there was no main effect of SRH upon HbA1c (b = .16, 95% CI: .08-.39), we found a significant interaction between gender and SRH on HbA1c (b = -.50, 95% CI: -.97 to -.03). In race by gender-stratified models, SRH (b = .53, 95% CI: .00-1.07) was associated with HbA1c in Black men. SRH was not associated with HbA1c in White men, White women, or Black women. CONCLUSION Combined race and gender differences may exist in the link between SRH and glycemic control in DM. Specifically, Black men with DM may be more attuned to the relationship between their overall health and their glycemic control.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Maryam Moghani Lankarani
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA
| | - John D Piette
- VA Center for Clinical Management Research, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - James E Aikens
- Department of Family Medicine, Michigan Medicine, Ann Arbor, MI, USA
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Willadsen TG, Siersma V, Nielsen ABS, Køster-Rasmussen R, Guassora AD, Jarbøl DE, Eusebi P, Malterud K, Reventlow S, de Fine Olivarius N. The effect of structured personal care on diabetes symptoms and self-rated health over 14 years after diabetes diagnosis. Prim Care Diabetes 2018; 12:354-363. [PMID: 29705674 DOI: 10.1016/j.pcd.2018.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/23/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Abstract
AIMS To explore the effect of structured personal care on diabetes symptoms and self-rated health over 14 years after diabetes diagnosis while patients are gradually diagnosed with other chronic conditions (multimorbidity). METHODS Post hoc analysis of the Danish randomized controlled trial Diabetes Care in General Practice including 1381 patients newly diagnosed with type 2 diabetes. The effect of structured personal care compared with routine care on diabetes symptoms and self-rated health was analysed 6 and 14 years after diagnosis with a generalized multilevel Rasch model. RESULTS Structured personal care reduced the overall likelihood of reporting diabetes symptoms at the end of the intervention (OR 0.79; 95% CI: 0.64-0.97), but this effect was not explained by glycaemic control or multimorbidity. There was no effect of the intervention on diabetes symptoms after 14 years or on self-rated health after 6 years or 14 years. CONCLUSIONS Structured personal care had a beneficial effect on diabetes symptoms 6 years after diagnosis, but not on self-rated health at either follow up point. To optimally manage patients over time it is important to supplement clinical information by information provided by the patients.
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Affiliation(s)
- Tora Grauers Willadsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anni Brit Sternhagen Nielsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus Køster-Rasmussen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ann Dorrit Guassora
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Paolo Eusebi
- Section of Neurology, Department of Medicine, University of Perugia, Perugia, Italy; Health Planning Service, Department of Epidemiology, Regional Health Authority of Umbria, Perugia, Italy
| | - Kirsti Malterud
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Research Unit for General Practice, Uni Research Health, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Susanne Reventlow
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Niels de Fine Olivarius
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Peyrot M, Bailey TS, Childs BP, Reach G. Strategies for implementing effective mealtime insulin therapy in type 2 diabetes. Curr Med Res Opin 2018; 34:1153-1162. [PMID: 29429377 DOI: 10.1080/03007995.2018.1440200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2D) is a growing global epidemic. Due to the progressive nature of the disease, many people with T2D require insulin at some point, most commonly a long-acting (basal) insulin to assist with 24-h control of glucose levels. OBJECTIVE This opinion paper provides an overview of considerations for primary care providers (PCPs) in intensifying the treatment regimen when basal insulin therapy is inadequate. RESULTS Control of mealtime hyperglycemia, in addition to fasting hyperglycemia, has been shown to be crucial in reaching A1c goals of <7.0%. However, initiating and optimizing mealtime insulin therapy can be challenging for both people with T2D and PCPs, due to a perceived lack of efficacy and burden of insulin treatment, causing "psychological insulin resistance" in people with T2D and clinical inertia among PCPs. Successful implementation of mealtime insulin therapy requires not only choosing appropriate treatment strategies, but also addressing patient-related behavioral and emotional barriers. Simplified treatment algorithms, combined with the use of advanced technology (devices such as insulin pens, pumps, and patches), and collaborative decision-making can help decrease barriers to effective mealtime insulin therapy. CONCLUSIONS It is possible to implement an effective basal-bolus insulin regimen in people with T2D in a way that improves glucose control while minimizing negative effects on quality-of-life, treatment satisfaction, and psychological well-being.
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Affiliation(s)
- Mark Peyrot
- a Loyola University Maryland , Baltimore , MD , USA
| | | | | | - Gérard Reach
- d Department of Endocrinology, Diabetes and Metabolic Diseases , Avicenne Hospital AP-HP , Bobigny , France
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Modarresnia L, Golgiri F, Madani NH, Emami Z, Tanha K. Restless Legs Syndrome in Iranian People With Type 2 Diabetes Mellitus: The Role in Quality of Life and Quality of Sleep. J Clin Sleep Med 2018; 14:223-228. [PMID: 29351820 PMCID: PMC5786841 DOI: 10.5664/jcsm.6938] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/13/2017] [Accepted: 10/23/2017] [Indexed: 01/06/2023]
Abstract
STUDY OBJECTIVES To investigate the prevalence of restless legs syndrome (RLS) in patients with type 2 diabetes mellitus (T2DM) and explore its role in quality of life (QoL) and quality of sleep of these patients. METHODS This is a cross-sectional study performed on 210 Iranian people with T2DM. The diagnosis of RLS was established based on the essential diagnostic criteria for RLS recommended by the National Institutes of Health. Sleep quality and QoL were assessed in all participants using Pittsburgh Sleep Quality Index and EuroQol five-dimension questionnaire, respectively. Regression models were used for final analysis of data. RESULTS The prevalence of RLS was 19.5%; of whom 38.1% had poor quality of sleep. Male sex, being single, body mass index (BMI), and RLS were associated with poor quality of sleep. Patients with RLS were almost three times as likely as the patients without RLS to have poor sleep quality. Moreover, being female, BMI value, level of glycosylated hemoglobine (HbA1C), and RLS were associated with lower QoL. RLS lowers the score of QoL even more than BMI and HbA1C. In addition, the QoL and sleep quality of this population of patients with diabetes have not been affected by the severity of RLS as well as presence or absence of neuropathy. CONCLUSIONS RLS has an independent and significant role in sleep quality and QoL in the patients with diabetes. Neuropathy with RLS does not confer any additive burden on QoL and sleep quality of this population of patients with diabetes.
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Affiliation(s)
- Leila Modarresnia
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fatemeh Golgiri
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Nahid Hashemi Madani
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zahra Emami
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Kiarash Tanha
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Aro AK, Karjalainen M, Tiihonen M, Kautiainen H, Saltevo J, Haanpää M, Mäntyselkä P. Glycemic control and health-related quality of life among older home-dwelling primary care patients with diabetes. Prim Care Diabetes 2017; 11:577-582. [PMID: 28754430 DOI: 10.1016/j.pcd.2017.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/30/2017] [Accepted: 07/08/2017] [Indexed: 11/22/2022]
Abstract
AIMS To evaluate the health-related quality of life (HRQoL) and functional capacity in relation to glycemic control among older home-dwelling primary care patients. METHODS Electronic patient records were used to identify 527 people over 65 years with diabetes. Of these, 259 randomly selected subjects were invited to a health examination and 172 of them attended and provided complete data. The participants were divided into three groups based on the HbA1c: good (HbA1c<48mmol/mol (N=95)), intermediate (HbA1c 48-57mmol/mol (N=48)) and poor (HbA1c>57mmol/mol (N=29)) glycemic control. HRQoL was measured with the EuroQol EQ-5D questionnaire. Functional and cognitive capacity and mental well-being were assessed with the Lawton Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15). RESULTS EQ-5D scores for good, intermediate and poor glycemic control were 0.78; 0.74 and 0.70, p=0.037. Sub-items of mobility (p=0.002) and self-care were the most affected (p=0.031). Corresponding trend was found for IADL, p=0.008. A significant correlation was found between MMSE scores and HbA1c. CONCLUSION Older primary care home-dwelling patients with diabetes and poorer glycemic control have lower functional capacity and HRQoL, especially in regard to mobility and self-care.
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Affiliation(s)
- Anna-Kaisa Aro
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland; Rantakylä Health Center, Siunsote, Finland.
| | - Merja Karjalainen
- Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland
| | - Miia Tiihonen
- School of Pharmacy, University of Eastern Finland, Finland
| | - Hannu Kautiainen
- Unit of Primary Health Care, Helsinki University Central Hospital, Finland
| | - Juha Saltevo
- Central Finland Central Hospital, Jyväskylä, Finland
| | - Maija Haanpää
- Etera Mutual Pension Insurance Company, Finland; Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland
| | - Pekka Mäntyselkä
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
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Bujang MA, Ismail M, Hatta NKBM, Othman SH, Baharum N, Lazim SSM. Validation of the Malay version of Diabetes Quality of Life (DQOL) Questionnaire for Adult Population with Type 2 Diabetes Mellitus. Malays J Med Sci 2017; 24:86-96. [PMID: 28951693 DOI: 10.21315/mjms2017.24.4.10] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 05/03/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE We aimed to validate the Malay version of Diabetes Quality of Life (DQOL) questionnaire for Malaysian adult population with type 2 diabetes mellitus (DM). METHODS This is a cross-sectional study to validate Malay version of DQOL among the adult diabetic patients. DQOL questionnaire has 46 items consist of three domains, namely Satisfaction Domain, Impact Domain and Worry Domain. Both forward and backward translations from the English version of DQOL into Malay version were performed. After the face validity of the Malay version was established, it was then pilot-tested. Finally, the validity and reliability of the final Malay version of DQOL questionnaire were evaluated. RESULTS There were 290 patients participated in this study with a mean (SD) age of 53.1 (10.0) years. The Cronbach's alpha coefficients of the overall items and the main domains were between 0.846 and 0.941. The Pearson's correlation coefficients for the three domains were between 0.228 and 0.451. HbA1C was found to be positively correlated with Impact Domain (P = 0.006). The Worry Domain was associated with diabetic retinopathy (P = 0.014) and nephropathy (P = 0.033). CONCLUSION The Malay version of diabetes quality of life (DQOL) questionnaire was found to be a valid and reliable survey instrument to be used for Malaysian adult patients with diabetes mellitus.
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Affiliation(s)
- Mohamad Adam Bujang
- Biostatistics Unit, Clinical Research Centre, Level 3 Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Mastura Ismail
- Seremban 2 Health Clinic, Jalan S2 A2, Seremban 2, 70300 Seremban, Negeri Sembilan, Malaysia
| | - Nur Khairul Bariyyah Mohd Hatta
- Biostatistics Unit, Clinical Research Centre, Level 3 Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Siti Haslina Othman
- Biostatistics Unit, Clinical Research Centre, Level 3 Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Nurakmal Baharum
- Biostatistics Unit, Clinical Research Centre, Level 3 Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Siti Sara Mat Lazim
- Biostatistics Unit, Clinical Research Centre, Level 3 Dermatology Block, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
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Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World J Diabetes 2017; 8:120-129. [PMID: 28465788 PMCID: PMC5394731 DOI: 10.4239/wjd.v8.i4.120] [Citation(s) in RCA: 286] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/24/2016] [Accepted: 01/18/2017] [Indexed: 02/05/2023] Open
Abstract
It is true that a primary goal of diabetes early diagnosis and treatment is quality of life (QoL). The term QoL is still confusing but it is agreed that it composes of four components: The physical component, mental, cogitative component, psychological and social component. Many articles have been written addressing those four components. During the last five years 15500 articles and reviews have been written addressing diabetes and coronary arterial disease, 16100 addressing diabetes and renal function, 28900 addressing diabetes and retinopathy, 16800 addressing diabetic foot ulcers and other 26300 addressing diabetic neuropathy. Moreover 17200 articles are dealing with diabetic sexual dysfunction, 24500 with the correlation of diabetes and depression 17500 about diabetes and dementia, only 1 about diabetes and family functioning and 1950000 about diabetes and QoL, indicating the worldwide interest. In order to confront this metabolic anomaly and its consequences, researchers developed numerous generic and disease specific psychometric tools. With the aid of those psychometric tools the scientific community has started to realize the gruesome effect of diabetes on patients’ lives. Diabetic’s QoL becomes worse when complications start to develop or comorbidities coexist. Dominant amongst complications, in health-related quality of life (HRQoL) lowering, but not related to risk factors (genetic, the weight of birth, or others) is coronary arterial disease followed by renal failure, blindness, and the combination of micro- and macro-vascular complications and in some studies by sexual dysfunction. Moreover many are the comorbidities which deteriorate further the effect of diabetes in a patient life. Among them obesity, hypertension, dyslipidemia, depression, arthritis are the most common. Most intriguing field for research is the interaction of diabetes and depression and in some cases the progression to dementia. Many aspects and combinations of actions are under researchers’ microscope regarding the improvement of HRQoL scores. Until now, the studies performed, have demonstrated little to moderate benefit. More of them are needed to draw safe conclusions on the topic of the best combination of actions to optimize the HRQoL scores.
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Lavernia CJ, Heiner AD, Villa JM, Alcerro JC, Rossi MD. Preoperative Glycemic Control on Total Joint Arthroplasty Patient-Perceived Outcomes and Hospital Costs. J Arthroplasty 2017; 32:6-10. [PMID: 27503695 DOI: 10.1016/j.arth.2016.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/13/2016] [Accepted: 07/05/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine the influence of preoperative glycemic control in diabetic patients undergoing a primary total hip or knee arthroplasty. We wanted to study patient-perceived outcomes in the medium term, the length of stay, hospital costs, and rate of short-term postoperative complications. METHODS One hundred twenty consecutive primary total joint arthroplasties (TJAs) performed in type 2 diabetic patients were stratified into 2 groups representing optimal and suboptimal preoperative glycemic control, based on serum levels of glycated hemoglobin (HbA1c), and those groups compared. RESULTS The mean follow-up time was 5.9 years (range, 2.1-10.7 years). Both groups demonstrated improvement in all patient-perceived outcome measures after TJA, with no significant difference detected in any change of a measure between the groups. No significant difference was detected in the length of stay, hospital costs, or rate of short-term postoperative complications between the groups. CONCLUSION Preoperative glycemic control in type 2 diabetic patients undergoing TJA did not affect patient-perceived outcomes in the medium term. Optimal vs suboptimal glycemic control in these patients also had no effect on the length of stay, hospital costs, or rate of short-term postoperative complications.
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Affiliation(s)
- Carlos J Lavernia
- The Center for Advanced Orthopedics at Larkin Community Hospital, South Miami, Florida
| | - Anneliese D Heiner
- The Center for Advanced Orthopedics at Larkin Community Hospital, South Miami, Florida; Arthritis Surgery Research Foundation, South Miami, Florida
| | - Jesus M Villa
- The Center for Advanced Orthopedics at Larkin Community Hospital, South Miami, Florida; Arthritis Surgery Research Foundation, South Miami, Florida
| | - Jose C Alcerro
- The Center for Advanced Orthopedics at Larkin Community Hospital, South Miami, Florida; Arthritis Surgery Research Foundation, South Miami, Florida
| | - Mark D Rossi
- Department of Physical Therapy, Florida International University, Miami, Florida
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Testing whether patients with diabetes and healthy people perceive the meaning of the items in the Persian version of the SF-36 questionnaire similarly: a differential item functioning analysis. Qual Life Res 2016; 26:835-845. [PMID: 27699556 DOI: 10.1007/s11136-016-1419-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 01/04/2023]
Abstract
PURPOSE It has been rarely studied whether observed disparity in health-related quality-of-life (HRQoL) scores between patients with diabetes and healthy individuals is due to differential item functioning (DIF) or a true difference in the underlying construct. This study aimed to examine DIF in the SF-36 questionnaire and its effect on comparing HRQoL scores between patients with diabetes and healthy people. METHODS The sample consisted of 230 patients with type 2 diabetes and 642 healthy individuals who filled out the Persian version of the SF-36 questionnaire. To detect DIF across patients with diabetes and healthy individuals, multiple-group multiple-indicator multiple-causes model was used. In addition, item calibration strategy was used to determine whether the effect of item-level DIF was transferred to the scale level. RESULTS Nine out of thirty-six (25 %) items were detected as DIF, of which one item (11 %) was flagged as uniform and eight items (89 %) as non-uniform DIF. Most of the DIF items were detected in the mental health component which includes vitality, perceived mental health and social functioning subscales rather than in physical health component. Moreover, nonsignificant latent mean differences for general health perception and social functioning subscales became significant after DIF calibration. CONCLUSION The findings of the present study show that patients with diabetes and healthy individuals perceived some items in the SF-36 questionnaire differently. More importantly, in some subscales, the effect of item-level DIF was transferred to the scale level. Consequently, considerable caution should be taken in comparing HRQoL scores between patients with diabetes and healthy individuals.
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Gregg EW, Caspersen CJ. Review: Physical disability and the cumulative impact of diabetes in older adults. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/14746514050050010301] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
he already high and increasing prevalence of diabetes among older adults will make ageing-related outcomes like physical disability an increasingly important complication of diabetes. Disability is a key indicator of both overall morbidity and the success of public health efforts to compress the period of morbidity in old age for the overall population. Many cross-sectional and longitudinal studies have now associated diabetes with increased risk of disabilities in mobility and in instrumental and basic activities of living. The explanation for higher disability among persons with diabetes appears to be multifactorial with neuropathy, peripheral arterial disease, coronary heart disease, depression, obesity, visual impairment, and physical inactivity the most prominent factors. These factors are common in persons with diabetes and exert strong effects on risk of disability. Several promising interventions exist, ranging from exercise programmes and identification and treatment of depression, to long-term prevention of disability through better management of glycaemia and risk factors for cardiovascular disease. Preliminary findings from the U.S. Diabetes Surveillance System suggest that, like the general population, prevalence of physical disability may also have declined among persons with diabetes during the last decade. Ultimately, preventing disability will likely depend on a combination of secondary and tertiary prevention along with, ideally, preventing diabetes in the first place.
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Affiliation(s)
- Edward W Gregg
- Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Highway, NE Mailstop K-10, Atlanta, GA 30341, USA,
| | - Carl J Caspersen
- Division of Diabetes Translation, Centers for Disease Control and Prevention, 4770 Buford Highway, NE Mailstop K-10, Atlanta, GA 30341, USA
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Dario C, Toffanin R, Calcaterra F, Saccavini C, Stafylas P, Mancin S, Vio E. Telemonitoring of Type 2 Diabetes Mellitus in Italy. Telemed J E Health 2016; 23:143-152. [PMID: 27379995 DOI: 10.1089/tmj.2015.0224] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (DM) affects 382 million people worldwide. INTRODUCTION This study aimed at assessing whether telemonitoring (TM) of DM patients improves health-related quality of life (HRQoL). MATERIALS AND METHODS As part of the RENEWING HEALTH project, 299 DM patients with HbA1c >7.0% were enrolled in a randomized controlled trial, with 208 patients in the TM group and 91 patients in the usual-care group. TM electronically transmitted glucose measurements to physicians during a 12-month follow-up. The SF-36v2 questionnaire was used to assess HRQoL. RESULTS In a total of 243 patients analyzed, the study did not identify any clinically important improvement in HRQoL, our primary endpoint. There was no statistically significant difference in HbA1c between the two groups; however, outpatient visits and planned hospitalizations were significantly reduced in the TM group (p < 0.0001 and p = 0.02). DISCUSSION The results regarding HRQoL might be, at least in part, an artifact stemming from the criteria used to select patients. TM reduced ambulatory visits and planned hospital admissions, an important result that plausibly reflects the fact that clinicians can strictly monitor their patients' health status without face-to-face contacts. CONCLUSIONS Enhancement of HRQoL should represent the most critical goal of DM healthcare delivery. Effects of TM on HRQoL of diabetic patients should be studied further.
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Affiliation(s)
- Claudio Dario
- 1 Arsenàl.IT, Veneto's Research Centre for eHealth Innovation , Treviso, Italy
| | - Roberto Toffanin
- 2 Local Health Authority of Alto Vicentino , Thiene-Schio, Italy
| | | | - Claudio Saccavini
- 1 Arsenàl.IT, Veneto's Research Centre for eHealth Innovation , Treviso, Italy
| | | | - Silvia Mancin
- 1 Arsenàl.IT, Veneto's Research Centre for eHealth Innovation , Treviso, Italy
| | - Elena Vio
- 1 Arsenàl.IT, Veneto's Research Centre for eHealth Innovation , Treviso, Italy
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Wan EYF, Fung CSC, Choi EPH, Wong CKH, Chan AKC, Chan KHY, Lam CLK. Main predictors in health-related quality of life in Chinese patients with type 2 diabetes mellitus. Qual Life Res 2016; 25:2957-2965. [DOI: 10.1007/s11136-016-1324-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 11/24/2022]
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Chawla KS, Talwalkar JA, Keach JC, Malinchoc M, Lindor KD, Jorgensen R. Reliability and validity of the Chronic Liver Disease Questionnaire (CLDQ) in adults with non-alcoholic steatohepatitis (NASH). BMJ Open Gastroenterol 2016; 3:e000069. [PMID: 27110379 PMCID: PMC4838661 DOI: 10.1136/bmjgast-2015-000069] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/25/2015] [Accepted: 11/30/2015] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Significant impairments in health-related quality of life (HRQL) in patients with non-alcoholic fatty liver disease have been previously described. The disease-specific HRQL among patients with non-alcoholic steatohepatitis (NASH), however, remains unknown. AIM To determine the degree of construct validity of the Chronic Liver Disease Questionnaire (CLDQ) in adults with NASH. METHODS Participants referred for the evaluation of histology-proven NASH at Mayo Clinic, Rochester, between 1996 and 2000, were evaluated. HRQL assessment by the Short-Form 36 (SF-36) Health Survey and CLD) was performed. The primary outcome was to determine the level of correlation between overall and subscale scores for the CLDQ and SF-36 instruments. RESULTS Among 79 participants (70%) with NASH completing both questionnaires (mean age, 51.2 years with 64% female gender), excellent reliability was noted for the CLDQ instrument. Significant reductions in all SF-36 domains (p<0.05 for all) including PCS and MCS scores (p<0.02 for both) among participants with NASH compared with normative data from an age-matched and sex-matched US general population sample was observed. Highly significant correlations were observed between overall CLDQ score with SF-36 PCS (r=0.82, p<0.0001) and SF-36 MCS (r=0.67, p<0.0001) scores. Similar degrees of correlation were observed between relevant subscales of the CLDQ and SF-36 as well. DISCUSSION The CLDQ has excellent reliability and validity of construct for HRQL assessment in adults with NASH when compared with the SF-36. Future investigations among participants with NASH require assessing the responsiveness of the CLDQ to medical therapies and disease progression.
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Affiliation(s)
| | - Jayant A Talwalkar
- Division of Gastroenterology and Hepatology , Mayo Clinic , Rochester, Minnesota , USA
| | - Jill C Keach
- Division of Gastroenterology and Hepatology , Mayo Clinic , Rochester, Minnesota , USA
| | - Michael Malinchoc
- Department of Biomedical Informatics , Mayo Clinic , Rochester, Minnesota , USA
| | | | - Roberta Jorgensen
- Division of Gastroenterology and Hepatology , Mayo Clinic , Rochester, Minnesota , USA
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Can metabolic control variables of diabetic patients predict their quality of life? ACTA ACUST UNITED AC 2016; 10:81-8. [DOI: 10.1016/j.jash.2015.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 11/05/2015] [Accepted: 11/11/2015] [Indexed: 01/14/2023]
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Papazafiropoulou AK, Bakomitrou F, Trikallinou A, Ganotopoulou A, Verras C, Christofilidis G, Bousboulas S, Μelidonis Α. Diabetes-dependent quality of life (ADDQOL) and affecting factors in patients with diabetes mellitus type 2 in Greece. BMC Res Notes 2015; 8:786. [PMID: 26666403 PMCID: PMC4678457 DOI: 10.1186/s13104-015-1782-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/30/2015] [Indexed: 11/10/2022] Open
Abstract
Background Diabetes mellitus type 2 (T2D) is a chronic metabolic disease with a great impact on health status and quality of life (QoL) in terms of physical, social, and psychological well-being. The aim of the present study was to measure diabetes-dependent QoL and affecting factors in patients with T2D. Methods Study population was consisted by 258 subjects with T2D attending diabetic outpatient clinics of General Hospitals of Piraeus “Tzaneio” and Nikaia “Ag.Panteleimon” during September–December 2014. The Audit of Diabetes-Dependent Quality of Life questionnaire was carried out in all study participants. Results Diabetes mellitus type 2 had a negative impact to QoL in 37.3 % of the study participants while 32.9 % believed that their life would have been better without the presence of T2D. Diabetes had negative impact on working life (−1.3 ± 0.6), health status (−1.3 ± 0.2), family (−1.3 ± 0.6) and sexual life (−1.3 ± 0.3), future perspectives (−1.3 ± 0.4) and dietary habits (−1.7 ± 0.2). The results of logistic regression analysis showed that QoL was related with age [odds ratio (OR) 0.94, 95 % confidence intervals (CIs) 0.91–1.98, P = 0.008] and marital status (OR 0.43, 95 %CIs 0.21–0.90, P = 0.03). Conclusions The results of the present study showed that T2D per se has a negative impact to patient’s QoL most of all affecting working life, health status, family and sexual life, future perspectives and dietary habits. Age and marital status were the only determinants of QoL.
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Affiliation(s)
- Athanasia K Papazafiropoulou
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Florentia Bakomitrou
- 3rd Internal Medicine Department and Diabetes Center, General Hospital of Nikaia, Athens, Greece.
| | - Aikaterini Trikallinou
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Asimina Ganotopoulou
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Chris Verras
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - George Christofilidis
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
| | - Stavros Bousboulas
- 3rd Internal Medicine Department and Diabetes Center, General Hospital of Nikaia, Athens, Greece.
| | - Αndreas Μelidonis
- 1st Department of Internal Medicine and Diabetes Center, Tzaneio General Hospital of Piraeus, 1 Zanni and Afentouli Street, 185 36, Piraeus, Greece.
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Mashitani T, Hayashino Y, Okamura S, Kitatani M, Furuya M, Iburi T, Kuwata H, Tsujii S, Ishii H. Diabetes treatment-related quality of life is associated with levels of self-care activities in insulin injection among Japanese patients with type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 8). Acta Diabetol 2015; 52:639-47. [PMID: 25854196 DOI: 10.1007/s00592-015-0725-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/06/2015] [Indexed: 11/25/2022]
Abstract
AIMS We investigated the association between diabetes treatment-related quality of life (QOL) and levels of self-care activities in insulin injection among Japanese patients with type 2 diabetes. METHODS Data from 1394 patients with type 2 diabetes on insulin therapy were obtained from a diabetes registry in Japan. We used the Diabetes Therapy-Related QOL (DTR-QOL) questionnaire and relative risk regression analysis to assess the independent association of high levels of self-care activities in insulin injection and DTR-QOL scores while adjusting for possible confounders. RESULTS The mean age, BMI and HbA1c level were 65.8 years, 24.8 kg/m(2) and 62 mmol/mol (7.8 %), respectively. The frequency of insulin injection omission was associated with DTR-QOL scores. In the multivariable-adjusted model, the relative risks for high levels of self-care activities in insulin injection was 1.15 (95 % confidence interval, 1.05-1.26) in the highest quintile compared with those in the lowest quintile of DTR-QOL scores. Subgroup analysis confirmed this association in patients <65 years. CONCLUSIONS DTR-QOL was associated with self-reported levels of self-care activities in insulin injection, particularly among Japanese patients <65 years with type 2 diabetes. DTR-QOL might be a useful tool to identify patients who consequently omit insulin. For patients with low DTR-QOL score, healthcare providers should discuss their treatment-related problems to prevent insulin injection omission.
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Affiliation(s)
- Tsuyoshi Mashitani
- Department of Diabetology, Nara Medical University, 840 Shijo-cho, Kashihara City, Nara, 634-8552, Japan,
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Nielsen ABS, Jensen P, Gannik D, Reventlow S, Hollnagel H, Olivarius NDF. Change in self-rated general health is associated with perceived illness burden: a 1-year follow up of patients newly diagnosed with type 2 diabetes. BMC Public Health 2015; 15:439. [PMID: 25924731 PMCID: PMC4431173 DOI: 10.1186/s12889-015-1790-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 04/22/2015] [Indexed: 11/15/2022] Open
Abstract
Background Diabetic patients’ lifestyle adaptations to improve glycaemic control are not always followed by improvements in self-rated general health (SRH). The perceived impact of diabetes on patients’ daily lives may influence changes in their SRH. This paper examines the association of illness severity, treatment, behavioural, and coping-related factors with changes in SRH from diagnosis of type 2 diabetes until one year later, in a population-based sample of 599 patients aged 40 years or over who were treated in general practice. Methods Change in SRH was estimated by a cumulative probit model with the inclusion of covariates related to SRH (e.g. illness severity at diagnosis, behaviour, treatment, and the perceived impact of diabetes on patients’ daily lives one year later). Results At diagnosis, 11.6% of patients reported very good, 35.1% good, 44.6% fair and 8.5% poor SRH. Physical inactivity, many diabetes-related symptoms, and cardiovascular disease were related to lower SRH ratings. On average SRH improved by 0.46 (95% CI: 0.37; 0.55) during the first year after diagnosis without inclusion of covariates. Mental and practical illness burden was the only factor associated with change in SRH, independent of patients’ diabetes severity and medical treatment (p = 0.03, multivariate analysis). Compared to otherwise similar patients without illness burden, increase in SRH was marginally smaller among patients who expressed minor illness burden, but much smaller among patients with more pronounced illness burden. Conclusions Much as one would expect, many patients increased their SRH during the first year after diabetes diagnosis. This increase in SRH was not associated with indicators of illness severity or factors reflecting socio-demographic circumstances, but patients experiencing illness burden had a smaller increase than those who reported no illness burden. We suggest that during the diabetes consultation, general practitioners explore further how patients manage their illness burden. We further suggest that diabetes guidelines extend their current focus on clinical and social aspects of diabetes to include questions on patient’s perceived illness burden and SRH. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1790-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anni Brit Sternhagen Nielsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Per Jensen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. .,Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
| | - Dorte Gannik
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Susanne Reventlow
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Hanne Hollnagel
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Niels de Fine Olivarius
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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Pichon-Riviere A, Irazola V, Beratarrechea A, Alcaraz A, Carrara C. Quality of life in type 2 diabetes mellitus patients requiring insulin treatment in Buenos Aires, Argentina: a cross-sectional study. Int J Health Policy Manag 2015; 4:475-80. [PMID: 26188812 DOI: 10.15171/ijhpm.2015.80] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/06/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Decision-makers have begun to recognize Health-Related Quality of Life (HRQoL) as an important and measurable outcome of healthcare interventions; and HRQoL data is increasingly being used by policy-makers to prioritize health resources. Our objective was to measure HRQoL in a group of Type 2 Diabetes Mellitus (T2DM) patients receiving insulin treatment in Buenos Aires, Argentina. METHODS We conducted a cross-sectional study of patients with T2DM over 21 years of age, treated with either Neutral Protamine Hagedorn (NPH) insulin or Insulin Glargine (IG), who had not changed their baseline schedule in the last 6 months. The recruitment was during 2006-7 in nine private diabetes specialists' offices in Buenos Aires, Argentina. A standardized diabetes-specific HRQoL questionnaire, the Audit of Diabetes Dependent Quality of Life (ADDQoL), was used. RESULTS A total of 183 patients were included (93 receiving NPH and 90 receiving IG). The mean QoL score was: 0.98 (SD: 0.89) and the diabetes specific QoL was: -1.49 (SD: 0.90). T2DM had a negative impact on HRQoL with a mean Average Weighted Impact (AWI) score on QoL of -1.77 (SD: 1.58). The greatest negative impact was observed for domains: 'worries about the future', 'freedom to eat', 'living conditions', 'sex life', and 'family life'. The mean AWI score was -1.71 (SD: 1.48) in patients treated with IG and -1.85 (SD: 1.68) in patients receiving NPH, this difference was not statistically significant. CONCLUSION The ADDQoL questionnaire is a tool that can be used in Argentina to measure the QoL of patients with diabetes when evaluating diabetes care programs. The scores of QoL in our selected population did not differ from those reported in high-income countries. We expect that the results of this study will increase healthcare providers' awareness of patients' perceived QoL and help to overcome the barriers that delay insulin treatment; mainly clinical inertia and patient resistance.
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Affiliation(s)
- Andres Pichon-Riviere
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.,School of Public Health, University of Buenos Aires, Buenos Aires, Argentina
| | - Vilma Irazola
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Andrea Beratarrechea
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.,Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Andrea Alcaraz
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Carolina Carrara
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.,Family and Community Medicine Division Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Glycaemic control and quality of life among ethnically diverse Malaysian diabetic patients. Qual Life Res 2014; 24:951-8. [PMID: 25352036 DOI: 10.1007/s11136-014-0830-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To assess the relationship between glycaemic control and quality of life (QoL) among a sample of Malaysians with type 2 diabetes mellitus. METHODS This study is a cross-sectional hospital-based study involving 256 patients from three major ethnic groups in Malaysia. Data about QoL were collected with the 18-item Audit of Diabetes Dependent QoL questionnaire. Other data about putative predictors of QoL including personal characteristics and disease-related factors were also collected. Hierarchical multiple linear regression was used to determine factors associated with QoL and to control for confounding variables. RESULTS The mean age of participants was 56.79 years. Participants were mostly women, employed and married and had attained secondary education. More than a third of the patients had a disease duration of more than 10 years, and about two-thirds had HbA1c ≥ 6.5 %. Those with desired glycaemic control had poorer QoL than those with less than desired glycaemic control moderated by the use of insulin. Hierarchical multiple linear regression showed that desired glycaemic control (HbA1c), diabetes worry, use of insulin, more than 10 years' duration of diabetes, neuropathy and retinopathy were associated with poor QoL, whereas being satisfied with waiting time for consultation was associated with better QoL. CONCLUSIONS The results of this study show that diabetes was associated with negative impact on quality of life. The use of insulin to achieve desired glycaemic control was particularly associated with negative impact on QoL.
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The association of type 2 diabetes patient and spouse illness representations with their well-being: a dyadic approach. Int J Behav Med 2014; 21:230-9. [PMID: 23436184 DOI: 10.1007/s12529-013-9296-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The aim of this study was to examine the relation between certain illness representations and the physical and psychological well-being of persons with type 2 diabetes mellitus and their spouses. PURPOSE In this study, we examined the relation of type 2 diabetes patients and their spouses' representations of illness consequences and timeline (chronicity and cyclicality/predictability) to the physical and psychological well-being of both. The interaction between patient and spouse illness representations was also studied. METHODS A dyadic analysis approach was employed, while the Actor-Partner Interdependence Model was used to examine dyadic effects. One hundred and sixty-eight individuals nested in 84 couples participated. RESULTS Regarding illness representations, both actor (i.e., the effects of a person's own characteristics on own outcomes) and partner (i.e., the effects of the partner's characteristics on a person's outcomes) effects were identified but only for patients' well-being. Certain significant interactions were also found: patients' timeline-cyclical representations were weakly associated with their anxiety and depression symptoms when spouses perceived diabetes as less unpredictable. Also, spouses' perceptions of consequences were more strongly related to their anxiety when patients perceived diabetes as less burdensome. CONCLUSIONS Overall, the findings indicate a type of synergy between patient and spouse illness representations. They also emphasize the interdependence between diabetes patients and their partners, and the need to examine adaptation to illness within a dyadic-regulation framework as well.
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Turk E, Rupel VP, Tapajner A, Isola A. Reliability and Validity of the Audit on Diabetes-Dependent Quality of Life (ADDQoL) and EQ-5D in Elderly Slovenian Diabetes Mellitus Type 2 Patients. Health (London) 2014. [DOI: 10.4236/health.2014.68091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Evidence-Informed Guidelines for Treating Frail Older Adults With Type 2 Diabetes: From the Diabetes Care Program of Nova Scotia (DCPNS) and the Palliative and Therapeutic Harmonization (PATH) Program. J Am Med Dir Assoc 2013; 14:801-8. [DOI: 10.1016/j.jamda.2013.08.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/16/2013] [Accepted: 08/06/2013] [Indexed: 12/11/2022]
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Darvishpoor Kakhki A, Abed saeedi Z. Health-related quality of life of diabetic patients in tehran. Int J Endocrinol Metab 2013; 11:e7945. [PMID: 24719629 PMCID: PMC3968983 DOI: 10.5812/ijem.7945] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 01/25/2013] [Accepted: 05/27/2013] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) is an important factor for self-management behaviors of diabetic patients. These behaviors have special importance in preventing complications of diabetes. OBJECTIVES This study has been conducted to evaluate HRQoL of diabetic patients referred to Tehran hospitals. PATIENTS AND METHODS In this descriptive study patients were selected from diabetes clinics of general hospitals in Tehran. A demographic and disease characteristics questionnaire and short-form of health survey (SF-36) were used for the data collection. The data were analyzed with SPSS software. RESULTS 140 diabetic patients with average age of 47.3 ± 12.7 years participated in this study. The range of HRQoL scores in different domains varied from 46.2 ± 13 for general health perceptions to 64.1 ± 26.6 for physical functioning. There were significant differences according to age, sex, educational level, type of diabetes, type of treatment, and different HRQoL dimensions. CONCLUSIONS HRQoL of diabetic patients is related to several variables. Considering of variables will be important for improving HRQoL of diabetic patients.
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Affiliation(s)
- Ali Darvishpoor Kakhki
- Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Ali Darvishpoor Kakhki, Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel:+98-2188202511, Fax:+98-21-88202521, E-mail:
| | - Zilla Abed saeedi
- Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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Liu LJ, Li Y, Sha K, Wang Y, He X. Patient assessment of chronic illness care, glycemic control and the utilization of community health care among the patients with type 2 diabetes in Shanghai, China. PLoS One 2013; 8:e73010. [PMID: 24039847 PMCID: PMC3769367 DOI: 10.1371/journal.pone.0073010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/23/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate the relationship between Patient Assessment of Chronic Illness Care in community health centers and self-management behaviors and glycemic control and to examine the relationship between Patient Assessment of Chronic Illness Care in community health centers and the utilization of community health centers for monitoring and treating diabetes among the patients with type 2 diabetes. METHODS A questionnaire including self-management behaviors, glycemic control, Patient Assessment of Chronic Illness Care in community health centers and the most often utilized medical institutions for monitoring and treating diabetes (community health centers vs. hospitals) was administered to 960 patients with type 2 diabetes in Shanghai, China. The relationships between Patient Assessment of Chronic Illness Care and self-management behaviors, self-management behaviors and glycemic control, Patient Assessment of Chronic Illness Care and glycemic control, Patient Assessment of Chronic Illness Care and the most often utilized medical institutions for monitoring and treating diabetes were examined. RESULTS Wilcoxon rank sum tests showed that the high scores of total Patient Assessment of Chronic Illness Care and five subscales in community health centers were positively related to almost all the proper self-management behaviors and good glycemic control (p<0.05). Almost all of the proper self-management behaviors were positively related to good glycemic control (p<0.01). High summary score of the Patient Assessment of Chronic Illness Care was positively associated with the utilization of community health centers for monitoring and treating diabetes (p<0.001). CONCLUSIONS Patient Assessment of Chronic Illness Care (implementation of the Chronic Care Model) in community health centers was associated with patients' self-management behaviors and glycemic control, and finally was associated with the utilization of community health centers for monitoring and treating diabetes.
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Affiliation(s)
- Li-Juan Liu
- Office of Medical Education, Training Department, the Second Military Medical University, Shanghai, People's Republic of China
| | - Yun Li
- Department of Cell and Developmental Biology, University of Illinois, Urbana-Champaign, Urbana, Illinois, United States of America
| | - Kun Sha
- Training Department, the Second Military Medical University, Shanghai, People's Republic of China
| | - Yue Wang
- Office of Medical Education, Training Department, the Second Military Medical University, Shanghai, People's Republic of China
- * E-mail: (XH); (YW)
| | - Xiang He
- Training Department, the Second Military Medical University, Shanghai, People's Republic of China
- * E-mail: (XH); (YW)
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Wong CKH, Lo YYC, Wong WHT, Fung CSC. The associations of body mass index with physical and mental aspects of health-related quality of life in Chinese patients with type 2 diabetes mellitus: results from a cross-sectional survey. Health Qual Life Outcomes 2013; 11:142. [PMID: 23964785 PMCID: PMC3765933 DOI: 10.1186/1477-7525-11-142] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 08/14/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study aimed to determine the associations of various clinical factors with generic health-related quality of life (HRQOL) scores among Hong Kong Chinese patients with type 2 diabetes mellitus (T2DM) in the outpatient primary care setting using the short-form 12 (SF-12). METHODS A cross-sectional survey of 488 Chinese adults with T2DM recruited from a primary care outpatient clinic was conducted from May to August 2008. Data on the standard Chinese (HK) SF-12 Health Survey and patients' socio-demographics were collected from face-to-face interviews. Glycaemic control, body mass index (BMI), chronic co-morbidities, diabetic complications and treatment modalities were determined for each patient through medical records. Associations of socio-demographic and clinical factors with physical component summary (PCS-12) and mental component summary scores (MCS-12) were evaluated using multiple linear regression. RESULTS The socio-demographic correlates of PCS-12 and MCS-12 were age, gender and BMI. After adjustment for socio-demographic variables, the BMI was negatively associated with PCS-12 but positively associated with MCS-12. The presence of diabetic complications was associated with lower PCS-12 (regression coefficient:-3.0 points, p < 0.05) while being on insulin treatment was associated with lower MCS-12 (regression coefficient:-5.8 points, p < 0.05). In contrast, glycaemic control, duration of T2DM and treatment with oral hypoglycaemic drugs were not significantly associated with PCS-12 or MCS-12. CONCLUSIONS Among T2DM subjects in the primary care setting, impairments in the physical aspect of HRQOL were evident in subjects who were obese or had diabetic complications whereas defects in the mental aspect of HRQOL were observed in patients with lower BMI or receiving insulin injections.
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Affiliation(s)
- Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong.
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Bourdel-Marchasson I, Druet C, Helmer C, Eschwege E, Lecomte P, Le-Goff M, Sinclair AJ, Fagot-Campagna A. Correlates of health-related quality of life in French people with type 2 diabetes. Diabetes Res Clin Pract 2013; 101:226-35. [PMID: 23831112 DOI: 10.1016/j.diabres.2013.05.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 04/04/2013] [Accepted: 05/30/2013] [Indexed: 01/31/2023]
Abstract
AIM Diabetes is known to impair health-related quality of life (HrQol). Our aim was to analyse a comprehensive set of potential determinants of HrQol in a large sample of patients with diabetes. METHODS This study is based on the ENTRED 2007 study, a representative sample of adults (18 years and older) with diabetes. Data were extracted from postal self-reported questionnaires (from patients and medical practitioners) and from reimbursements from the National health insurance data system. HrQol was assessed with the MOS SF-12 for mental (MCS) and physical (PCS) component summaries. Multivariate linear regression models were used to analyse the variables associated with HrQol. RESULTS SF-12 MCS and PCS were available in 2832 patients with T2DM, with a mean age 64 years (1715 males, 56%). Lower income, severe hypoglycaemic episodes, hospitalisation ≥24 h, instrumental daily living (IADL) restriction, low satisfaction for social support and an HbA1c within the 8.1-10.0% range were associated with lower MCS rating, whereas an older age and male gender were associated with higher MCS. Older age, female sex, higher BMI, lower income, insulin treatment, macrovascular complications, severe hypoglycaemic episodes, hospitalisation ≥24 h, and IADL restriction were associated with lower PCS values whereas having no need for social support was associated with higher PCS values. DISCUSSION HrQol associated factors are multiple but mainly linked with socio-demographic factors, diabetes complications and satisfaction for social support. A patient centred approach should be tested to prevent impairment of HrQol and thus to decrease the burden of diabetes. Assessment of social support should be included.
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Hayashino Y, Okamura S, Matsunaga S, Tsujii S, Ishii H. The association between problem areas in diabetes scale scores and glycemic control is modified by types of diabetes therapy: diabetes distress and care registry in Tenri (DDCRT 2). Diabetes Res Clin Pract 2012; 97:405-10. [PMID: 22554998 DOI: 10.1016/j.diabres.2012.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 03/04/2012] [Accepted: 04/03/2012] [Indexed: 11/19/2022]
Abstract
AIM To evaluate the joint association of Problem Areas in Diabetes (PAID) Scale scores and glycemic control with diabetes therapy. METHODS We used 3479 patients' data with type 1 and type 2. Modified Poisson regression analysis was used to estimate relative risks (RRs) for poor glycemic control (HbA1c≥7.0%) across quartiles of PAID scores. RESULTS Compared with the 1st quartile of PAID score, multivariable-adjusted RRs for poor glycemic control were 0.99 (95%CI, 0.87-1.11), 1.05 (95%CI, 0.93-1.18), and 1.12 (95%CI, 1.00-1.27), respectively, for 2nd to 4th quartiles, and we observed significant trend (p for trend=0.03). We observed significant interaction of PAID score and HbA1c with diabetes therapy (p=0.0469). In patients receiving diet only therapy, the RRs for poor glycemic control were 1.38 (95%CI, 0.93-2.05), 1.18 (95%CI, 0.51-5.13), and 1.81 (95%CI, 1.16-2.79), respectively for 2nd to 4th quartiles of PAID score compared with the 1st quartile (p for trend=0.025); while we did not observe significant association between PAID and poor glycemic control in patients receiving medication therapy. CONCLUSIONS Diabetes distress measured by PAID survey was associated with poor glycemic control, and this association was modified by diabetes therapy.
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Affiliation(s)
- Yasuaki Hayashino
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan.
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Ali MK, Feeney P, Hire D, Simmons DL, O'Connor PJ, Ganz-Lord F, Goff D, Zhang P, Anderson RT, Narayan KMV, Sullivan MD. Glycaemia and correlates of patient-reported outcomes in ACCORD trial participants. Diabet Med 2012; 29:e67-74. [PMID: 22141437 DOI: 10.1111/j.1464-5491.2011.03532.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Post-hoc evaluation of relationships between first-year change in glycaemic control (HbA(1c) ) and change in patient-reported outcomes among ACCORD health-related quality of life (HRQoL) substudy participants. METHODS Data from 2053 glycaemia-trial subjects were analysed. We assessed physical and mental health status (36-Item Short Form Health Survey, Version-2), symptom count and severity (Diabetes Symptoms Distress Checklist) and treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire). Linear mixed models were used to test relationships between 1-year changes in HbA(1c) and patient reported outcomes sequentially adjusting for correlates (baseline characteristics, baseline patient reported outcomes, treatment assignment, frequency of clinical contact and post-randomization weight change plus new complications). RESULTS Poorer baseline control of HbA(1c) and cardiovascular disease risk factors predicted greater one-year improvements in treatment satisfaction. Similarly, poorer baseline patient reported outcome scores all individually predicted greater 1-year improvement in that same outcome. Accounting for baseline and post-randomization characteristics and treatment arm, 1-year change in HbA(1c) was unrelated to changes in overall physical or mental health; however, every one percentage-point (10.9 mmol/mol) reduction in HbA(1c) was associated with lower symptom count (β = 0.599; P = 0.012), lower symptom distress (β = 0.051; P = 0.001), and higher treatment satisfaction (β = -2.514; P < 0.001). CONCLUSIONS Independent of all relevant covariates, better glycaemic control over 1 year was associated with reduced patient-reported diabetes symptoms and symptom distress, and increased treatment satisfaction, but not overall physical and mental health. Further investigation is required to understand the specific psychosocial mechanisms that affect how patients value health and treatments.
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Affiliation(s)
- M K Ali
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Wang HF, Yeh MC. The quality of life of adults with type 2 diabetes in a hospital care clinic in Taiwan. Qual Life Res 2012; 22:577-84. [DOI: 10.1007/s11136-012-0178-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2012] [Indexed: 10/28/2022]
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Tamir O, Wainstein J, Abadi-Korek I, Horowitz E, Shemer J. The patient-perceived difficulty in diabetes treatment (PDDT) scale identifies barriers to care. Diabetes Metab Res Rev 2012; 28:246-51. [PMID: 21990234 DOI: 10.1002/dmrr.1300] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The objective of this study is to describe the design and validation of a newly developed brief, treatment-focused scale for use with type 1 and type 2-diabetes, exploring patient-perceived difficulties that are associated with treatment. METHODS The content of the construct was derived from consultation with experts, from existing instruments and the literature, as well as from diabetic patients. The original draft was comprised of 11 attributes. Based on an interim analysis, an additional 12th attribute was added. The final scale was tested on 988 diabetic patients from 25 practices in Israel. Respondents also completed a diabetes-specific quality of life (QoL) questionnaire and indicated their current perceived overall health status. RESULTS The patient-perceived difficulty of diabetes treatment (PDDT) scale contains 12 items reflecting diabetes-treatment characteristics: adherence to self-monitoring of glucose schedule, frequency of self-monitoring of glucose, adherence to medication administration schedule, frequency of medication administration, multiple number of medications, synchronization between meals and medications, dependence on the medications, pain associated with treatment, diet restrictions, self-care, multiple healthcare providers, and costs of treatment. Response rate to all attributes was very high. Construct validity was shown by significant correlations between PDDT attributes and diabetes-specific quality of life (r = 0.31-0.46) and self-report adherence to recommended treatment (r = 0.14-0.28), as well as between overall perceived difficulty and diabetes-specific quality of life (r = 0.60). Furthermore, the PDDT items showed discriminant capabilities with respect to known groups of patients. CONCLUSIONS The PDDT scale is a simple and valid instrument that may assist in identifying potential barriers in adherence to recommended treatments and to new treatment options.
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Affiliation(s)
- Orly Tamir
- Israel Center for Technology Assessment in Health Care, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel.
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Maatouk I, Wild B, Wesche D, Herzog W, Raum E, Müller H, Rothenbacher D, Stegmaier C, Schellberg D, Brenner H. Temporal predictors of health-related quality of life in elderly people with diabetes: results of a German cohort study. PLoS One 2012; 7:e31088. [PMID: 22292092 PMCID: PMC3265531 DOI: 10.1371/journal.pone.0031088] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 01/02/2012] [Indexed: 11/26/2022] Open
Abstract
Background The aim of the study was to determine predictors that influence health-related quality of life (HRQOL) in a large cohort of elderly diabetes patients from primary care over a follow-up period of five years. Methods and Results At the baseline measurement of the ESTHER cohort study (2000–2002), 1375 out of 9953 participants suffered from diabetes (13.8%). 1057 of these diabetes patients responded to the second-follow up (2005–2007). HRQOL at baseline and follow-up was measured using the SF-12; mental component scores (MCS) and physical component scores (PCS) were calculated; multiple linear regression models were used to determine predictors of HRQOL at follow-up. As possible predictors for HRQOL, the following baseline variables were examined: treatment with insulin, glycated hemoglobin (HbA1c), number of diabetes related complications, number of comorbid diseases, Body-Mass-Index (BMI), depression and HRQOL. Regression analyses were adjusted for sociodemographic variables and smoking status. 1034 patients (97.8%) responded to the SF-12 both at baseline and after five years and were therefore included in the study. Regression analyses indicated that significant predictors of decreased MCS were a lower HRQOL, a higher number of diabetes related complications and a reported history of depression at baseline. Complications, BMI, smoking and HRQOL at baseline significantly predicted PCS at the five year follow-up. Conclusions Our findings expand evidence from previous cross-sectional data indicating that in elderly diabetes patients, depression, diabetes related complications, smoking and BMI are temporally predictive for HRQOL.
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Affiliation(s)
- Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany.
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Vadstrup ES, Frølich A, Perrild H, Borg E, Røder M. Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling. Health Qual Life Outcomes 2011; 9:110. [PMID: 22152107 PMCID: PMC3251531 DOI: 10.1186/1477-7525-9-110] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 12/07/2011] [Indexed: 11/29/2022] Open
Abstract
Background Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients. Methods We randomised 143 type 2 diabetes patients to either a six-month multidisciplinary group-based rehabilitation programme including patient education, supervised exercise and a cooking-course or a six-month individual counselling programme. HRQOL was measured by Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and self-rated health was measured by Diabetes Symptom Checklist - Revised (DCS-R). Results In both groups, the lowest estimated mean scores of the SF36 questionnaire at baseline were "vitality" and "general health". There were no significant differences in the change of any item between the two groups after the six-month intervention period. However, vitality-score increased 5.2 points (p = 0.12) within the rehabilitation group and 5.6 points (p = 0.03) points among individual counselling participants. In both groups, the highest estimated mean scores of the DSC-R questionnaire at baseline were "Fatigue" and "Hyperglycaemia". Hyperglycaemic and hypoglycaemic distress decreased significantly after individual counselling than after group-based rehabilitation (difference -0.3 points, p = 0.04). No between-group differences occurred for any other items. However, fatigue distress decreased 0.40 points within the rehabilitation group (p = 0.01) and 0.34 points within the individual counselling group (p < 0.01). In the rehabilitation group cardiovascular distress decreased 0.25 points (p = 0.01). Conclusions A group-based rehabilitation programme did not improve health-related quality of life and self-rated health more than an individual counselling programme. In fact, the individual group experienced a significant relief in hyper- and hypoglycaemic distress compared with the rehabilitation group. However, the positive findings of several items in both groups indicate that lifestyle intervention is an important part of the management of type 2 diabetes patients.
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Affiliation(s)
- Eva S Vadstrup
- Department of Endocrinology and Gastroenterology, Bispebjerg University Hospital, Copenhagen, Denmark.
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Hajos TRS, Pouwer F, de Grooth R, Holleman F, Twisk JWR, Diamant M, Snoek FJ. The longitudinal association between glycaemic control and health-related quality of life following insulin therapy optimisation in type 2 diabetes patients. A prospective observational study in secondary care. Qual Life Res 2011; 21:1359-65. [PMID: 22065281 PMCID: PMC3438404 DOI: 10.1007/s11136-011-0051-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2011] [Indexed: 12/02/2022]
Abstract
Purpose To test whether improvement in glycosylated haemoglobin (HbA1c) as a marker of glycaemic control, following intensifying insulin therapy, is associated with improvements in HRQoL. Methods Dutch sub-optimally controlled (HbA1c > 7%) type 2 diabetes patients (N = 447, mean age 59 ± 11) initiated insulin glargine therapy. Data were collected at baseline, 3 and 6 months, and included HbA1c and measures of HRQoL: diabetes symptom distress (Diabetes Symptom Checklist-revised; DSC-r), fear of hypoglycaemia (Hypoglycaemia Fear Survey; HFS-w) and emotional well-being (WHO-5 wellbeing index). Results HbA1c decreased from 8.8 ± 1.4% to 8.0 ± 1.2% and 7.7 ± 1.3% at 3 and 6 months follow-up, respectively (P < 0.001), DSC-r score improved from 17.7 ± 14.7 to 14.3 ± 13.3 and 13.6 ± 13.3 (P < 0.001). HFS-w score did not significantly change. WHO-5 score increased from 56 ± 23 to 62 ± 23 and 65 ± 22 P < 0.001). A modest, significant association was found between HbA1c and WHO-5 score (B = −1.8, 95% CI: −2.7 to −0.8) and HbA1c and DSC-r score (B = 1.0, 95% CI: 0.4 to 1.6). No such association was found for HFS-w score. Conclusions An association between improvement in HbA1c by means of optimising insulin therapy and improvement in HRQoL in type 2 diabetes patients has been observed. A weak, yet significant longitudinal association was found between improved HbA1c and emotional well-being and diabetes symptom distress.
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Affiliation(s)
- T R S Hajos
- Department of Medical Psychology, VU University Medical Center (VUMC), Amsterdam, The Netherlands.
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Fal AM, Jankowska B, Uchmanowicz I, Sen M, Panaszek B, Polanski J. Type 2 diabetes quality of life patients treated with insulin and oral hypoglycemic medication. Acta Diabetol 2011; 48:237-42. [PMID: 21191622 PMCID: PMC3162186 DOI: 10.1007/s00592-010-0244-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Accepted: 12/08/2010] [Indexed: 11/08/2022]
Abstract
The aim of the study is to assess QoL depending on the choice of therapeutic regimen. From a total of 200 patients, half (n = 100) were treated with insulin (66% were females, age 52.1 ± 7.4-group A), the remaining 100 received oral treatment (74% females, age 63.3 ± 8.3-group B). For self-assessment of QoL, the WHOQOL-BREF questionnaire was used. In group A, we found a negative influence of increased level of glycemia and occurrence of coexisting diseases in the somatic domain . In the psychological domain, frequent checkups showed a positive influence while circulatory failure produced negative results. For social domain, disobeying of recommended diet was strongly negative as well as increased levels of glycemia and coexisting disease for environmental domain. In group B, for somatic domain, correct values of glycemia and place of residence had positive influence. Incorrect values of BMI, WHR, and co-existing disease influenced the same domain negatively. In the psychological domain, a positive influence had place of residence but a negative BMI, ischemic heart disease, clinical complications. For environmental domain, a positive influence had correct values of glycemia but a negative BMI, ischemic heart disease and clinical complications. Finally, the social domain for group B was negatively influenced by BMI, ischemic heart disease, clinical complications, and lack of regular supervisions of glycemia level. A higher assessment of quality of life was found in the group of patients treated with oral hypoglycemic medicines in somatic and environmental domains, and in the group of patients treated with insulin in psychological domain.
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Affiliation(s)
- Andrzej M Fal
- Department of Public Health, Wroclaw Medical University, Poland.
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Nielsen ABS, Gannik D, Siersma V, Olivarius NDF. The relationship between HbA1c level, symptoms and self-rated health in type 2 diabetic patients. Scand J Prim Health Care 2011; 29:157-64. [PMID: 21707235 PMCID: PMC3347958 DOI: 10.3109/02813432.2011.585542] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Improving glycaemic control is generally supposed to reduce symptoms experienced by type 2 diabetic patients, but the relationships between glycated haemoglobin (HbA(1c)), diabetes-related symptoms, and self-rated health (SRH) are unclarified. This study explored the relationships between these aspects of diabetes control. DESIGN A cross-sectional study one year after diagnosis of type 2 diabetes. SUBJECTS A population-based sample of 606 type 2 diabetic patients, median age 65.6 years at diagnosis, regularly reviewed in primary care. MAIN OUTCOME MEASURES The relationships between HbA(1c), diabetes-related symptoms, and SRH. RESULTS The patients' median HbA(1c) was 7.8 (reference interval: 5.4-7.4 % at the time of the study). 270 (45.2%) reported diabetes-related symptoms within the past 14 days. SRH was associated with symptom score (γ = 0.30, p < 0.001) and HbA(1c) (γ = 0.17, p = 0.038) after correction for covariates. The relation between HbA(1c) and symptom score was explained by SRH together with other confounders, e.g. hypertension (γ = 0.02, p = 0.40). The relation between the symptom fatigue and SRH was not explained by symptom score and significantly modified the direct association between symptom score and SRH. CONCLUSIONS Symptom relief may not occur even when HbA(1c) level is at its lowest average level in the natural history of diabetes, and symptoms and SRH are closely linked. Monitoring symptoms in the clinical encounter to extend information on disease severity, as measured e.g. by HbA(1c), may help general practitioners and patients to understand the possible impact of treatments and of disease manifestations in order to obtain optimum disease control.
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Affiliation(s)
- Anni B S Nielsen
- Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, Denmark.
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