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Volčanšek Š, Lunder M, Janež A. Health-Related Quality of Life Assessment in Older Patients with Type 1 and Type 2 Diabetes. Healthcare (Basel) 2023; 11:2154. [PMID: 37570394 PMCID: PMC10418676 DOI: 10.3390/healthcare11152154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Type 1 (T1D) and type 2 diabetes (T2D) are determinants of health-related outcomes including health-related quality of life (HRQOL). We aimed to determine differences in HRQOL between older adults with T1D and T2D and specific factors influencing HRQOL in this age group. This study used a cross-sectional design with 56 age- and HbA1c-matched T1D and T2D patients (aged 68.9 ± 7.8 years; 55% had T2D). We employed several validated questionnaires (Short Form-36 (SF-36) and the EuroQol-5 Dimensions/Visual Analog Scale (VAS)) to investigate the relationships between HRQOL domains and diabetes type, glycemic control, complications, and comorbidities. T1D was associated with better self-reported general health (assessed with the SF-36 general health domain (p = 0.048) and the EuroQol-5 VAS (p = 0.002), whereas no significant differences in the other SF-36 domains, self-reported diabetes distress, anxiety, or depression were found. Most HRQOL domains were not associated with HbA1c or the presence of diabetes complications. The most significant reduction in HRQOL was experienced by patients with higher BMIs, irrespective of the diabetes type. The obtained HRQOL data could be used in clinical settings for evidence-based patient education focused on specific subgroups of patients, as well as in national healthcare policies, e.g., interventions designed to alleviate obesity.
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Affiliation(s)
- Špela Volčanšek
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Mojca Lunder
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Andrej Janež
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Qi X, Xu J, Chen G, Liu H, Liu J, Wang J, Zhang X, Hao Y, Wu Q, Jiao M. Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: multiple effects of social support on quality of life. Health Qual Life Outcomes 2021; 19:254. [PMID: 34772424 PMCID: PMC8588678 DOI: 10.1186/s12955-021-01881-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/04/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Elderly patients with type 2 diabetes mellitus are highly vulnerable due to severe complications. However, there is a contradiction in the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed the quality of life and its interfering factors in this patient population. METHODS In total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang Province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data. RESULTS The average quality of life score was - 29.25 ± 24.41. Poorly scored domains of quality of life were "Psychological feeling" (- 8.67), "Activity" (- 6.36), and "Emotion" (- 6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (1) directly (c' = 0.6831); (2) indirectly through self-management behavior (a1*b1 = 0.1773); and (3) indirectly through FPG control (a2*b2 = 0.1929). Self-management behavior influenced the quality of life directly and indirectly through FPG control. CONCLUSION Improving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to the elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.
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Affiliation(s)
- Xinye Qi
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Jiao Xu
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Guiying Chen
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang China
| | - Huan Liu
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Jingjing Liu
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Jiahui Wang
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Xin Zhang
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Yanhua Hao
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
| | - Mingli Jiao
- Department of Health Policy, Health Management College, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
- Department of Social Medicine, School of Public Health, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, Heilongjiang China
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Fuentes-Merlos Á, Orozco-Beltrán D, Quesada Rico JA, Reina R. Quality-of-Life Determinants in People with Diabetes Mellitus in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136929. [PMID: 34203455 PMCID: PMC8297329 DOI: 10.3390/ijerph18136929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 01/22/2023]
Abstract
This study aims to analyze self-perceived health and lifestyles in the European Union Member States Iceland, Norway, and the United Kingdom, examining associations with diabetes prevalence; and to identify the demographic, economic and health variables associated with diabetes in this population. We performed a cross-sectional study of 312,172 people aged 15 years and over (150,656 men and 161,516 women), using data collected from the European Health Interview Survey (EHIS). The EHIS includes questions on the health status and health determinants of the adult population, as well as health care use and accessibility. To estimate the magnitudes of the associations with diabetes prevalence, we fitted multivariate logistic models. The EHIS data revealed a prevalence of diabetes in Europe of 6.5% (n = 17,029). Diabetes was associated with being physically inactive (OR 1.14; 95% CI 1.02–1.28), obese (OR 2.75; 95% CI 2.60–2.90), male (OR 1.46; 95% CI 1.40–1.53) and 65–74 years old (OR 3.47; 95% CI 3.09–3.89); and having long-standing health problems (OR 7.39; 95% CI, 6.85–7.97). These results were consistent in the bivariate and multivariate analyses, with an area under the receiver operating characteristic curve of 0.87 (95% CI 0.87–0.88). In a large European health survey, diabetes was clearly associated with a poorer perceived quality of life, physical inactivity, obesity, and other comorbidities, as well as non-modifiable factors such as older age and male sex.
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Affiliation(s)
- Álvaro Fuentes-Merlos
- Department of Primary Health Care, San Juan de Alicante University Hospital, 03550 San Juan de Alicante, Spain;
| | - Domingo Orozco-Beltrán
- Department of Clinical Medicine, Miguel Hernández University, 03550 San Juan de Alicante, Spain;
| | - Jose A. Quesada Rico
- Department of Clinical Medicine, Miguel Hernández University, 03550 San Juan de Alicante, Spain;
- Correspondence: ; Tel.: +34-965-919-449
| | - Raul Reina
- Department of Sport Sciences, Sport Research Centre, Miguel Hernández University, 03202 Elche, Spain;
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Tekir O, Çevik C, Özsezer Kaymak G, Kaya A. THE EFFECT OF DIABETES SYMPTOMS ON QUALITY OF LIFE IN INDIVIDUALS WITH TYPE 2 DIABETES. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2021; 17:186-193. [PMID: 34925566 PMCID: PMC8665249 DOI: 10.4183/aeb.2021.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of symptoms of diabetes on the quality of life of individuals with Type 2 diabetes. METHOD The study used a cross-sectional design. No sampling procedure was employed in the study; instead, 410 individuals presenting to the Balikesir Atatürk City Hospital Endocrinology and Internal Medicine Polyclinics between December 2016 and July 2017, diagnosed with Type 2 diabetes, and meeting the inclusion criteria were enrolled in the study sample. The study data were collected with a "Socio-demographic Characteristics Questionnaire", the "Diabetes Symptom Checklist", and the "SF-36 Quality of Life Questionnaire". RESULTS The participants obtained the highest mean scores from the hyperglycemia subscale of the Diabetes Symptoms Checklist (3.35±0.60) and the mental health subscale of the SF-36 Quality of Life Questionnaire (50.65±8.10). The hypoglycemia, cardiology, psychology, and neurology variables included in the model were statistically significant and predicted 35% of the mental subscale score of the SF 36 questionnaire. SF 36 physical subscale score increased as the hypoglycemia, cardiology, psychology, and neurology scores decreased (p<0.05). CONCLUSION The participants obtained high scores from the hyperglycemia subscale of the diabetes symptom checklist and mental health subscale of the quality of life questionnaire. Diabetes symptoms were found to affect the quality of life of individuals with diabetes.
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Affiliation(s)
- O. Tekir
- Izmir Demokrasi University - Faculty of Health Sciences, Department of Nursing, Izmir, Turkey
| | - C. Çevik
- Balikesir University - Faculty of Health Sciences, Department of Nursing, Balikesir, Turkey
| | - G. Özsezer Kaymak
- Çanakkale Onsekiz Mart University - Faculty of Health Sciences, Department of Nursing, Çanakkale, Turkey
| | - A. Kaya
- Balıkesir Atatürk City Hospital - Neonatal Intensive Care Unit, Balıkesir, Turkey
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Siggelkow H, Clarke BL, Germak J, Marelli C, Chen K, Dahl‐Hansen H, Glenister E, Bent‐Ennakhil N, Judge D, Mycock K, Bollerslev J. Burden of illness in not adequately controlled chronic hypoparathyroidism: Findings from a 13-country patient and caregiver survey. Clin Endocrinol (Oxf) 2020; 92:159-168. [PMID: 31721256 PMCID: PMC7027891 DOI: 10.1111/cen.14128] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To address knowledge gaps regarding burdens associated with not adequately controlled chronic hypoparathyroidism. DESIGN Global patient and caregiver survey. STUDY POPULATIONS Patients with chronic hypoparathyroidism not adequately controlled on conventional therapy and their caregivers. MEASUREMENTS Health-related quality of life (HRQoL) and health status were evaluated using the 36-item Short Form version 2 (SF-36 v2.0) and Five-Level EuroQoL 5 Dimensions (EQ-5D-5L) instruments, respectively. Hypoparathyroidism-associated symptoms were assessed by a disease-specific Hypoparathyroidism Symptom Diary and caregiver burden via the Modified Caregiver Strain Index (MCSI). RESULTS Data were obtained from 398 patients and 207 caregivers. Patients' self-rated hypoparathyroidism-related symptom severity was none (3%), mild (32%), moderate (53%) or severe (12%). Per the Hypoparathyroidism Symptom Diary, patients reported moderate, severe or very severe symptoms of physical fatigue (73%), muscle cramps (55%), heaviness in limbs (55%) and tingling (51%) over a 7-day recall period. Impacts (rated 'somewhat' or 'very much') were reported by 84% of patients for ability to exercise, 78% for sleep, 75% for ability to work and 63% for family relationships. Inverse relationships were observed between patient self-rated overall symptom severity and HRQoL and health status assessment scores-the greater the symptom severity, the lower the SF-36 and EQ-5D-5L scores. Caregiver burden increased with patient self-rated symptom severity: none, 1.7 MCSI; mild, 5.4 MCSI; moderate, 9.5 MCSI; and severe, 12.5 MCSI. CONCLUSION Patients with not adequately controlled hypoparathyroidism reported substantial symptoms and impacts. Greater patient symptom severity was associated with decreased patient HRQoL and health status assessments and increased caregiver burden.
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Affiliation(s)
- Heide Siggelkow
- Clinic of Gastroenterology and EndocrinologyUniversity of GöttingenGöttingenGermany
| | - Bart L. Clarke
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and NutritionRochesterMNUSA
| | - John Germak
- Shire International GmbH, a member of the Takeda group of companiesZugSwitzerland
| | - Claudio Marelli
- Shire International GmbH, a member of the Takeda group of companiesZugSwitzerland
| | - Kristina Chen
- Shire Human Genetic Therapies, Inc., a member of the Takeda group of companiesCambridgeMAUSA
| | | | | | - Nawal Bent‐Ennakhil
- Adelphi Real‐WorldAdelphi MillBollingtonUK
- Present address:
TakedaEUCAN Evidence & Data GenerationZurichSwitzerland
| | - Davneet Judge
- Adelphi Real‐WorldAdelphi MillBollingtonUK
- Present address:
RocheWelwyn Garden CityUK
| | | | - Jens Bollerslev
- Section of Specialized EndocrinologyOslo University HospitalOsloNorway
- Faculty of MedicineUniversity of OsloOsloNorway
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Tonetto IFDA, Baptista MHB, Gomides DDS, Pace AE. Quality of life of people with diabetes mellitus. Rev Esc Enferm USP 2019; 53:e03424. [DOI: 10.1590/s1980-220x2018002803424] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/15/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyze the quality of life of people with type 2 diabetes mellitus in the three levels of the healthcare system. Method: A quantitative, cross-sectional and descriptive study carried out in primary, secondary and tertiary healthcare units with individuals in outpatient care. The validated Diabetes-39 instrument was used to evaluate quality of life. Results: The sample consisted of 53 people. There was a decreasing tendency in the quality of life impairment from the primary to the tertiary care levels. In the total sample, there were differences between domains of quality of life with the variables gender, insulin use and occupation, greater perception of quality of life impairment and disease severity in people with higher rates of glycated hemoglobin. Conclusion: Quality of life tends to worse as the disease worsens. The results suggest that quality of life is related to sociodemographic and clinical variables, therefore, these should be considered in the care.
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Bani-issa W, Al-Shujairi AM, Patrick L. Association between quality of sleep and health-related quality of life in persons with diabetes mellitus type 2. J Clin Nurs 2018; 27:1653-1661. [DOI: 10.1111/jocn.14221] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Wegdan Bani-issa
- Department of Nursing; College of Health Sciences; University of Sharjah; Sharjah United Arab Emirates
| | - Arwa M Al-Shujairi
- Research Institute of Medical and Health Sciences; University of Sharjah; Sharjah United Arab Emirates
| | - Linda Patrick
- Faculty of Nursing; University of Windsor; Windsor ON USA
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Lin CY, Lee TY, Sun ZJ, Yang YC, Wu JS, Ou HT. Development of diabetes-specific quality of life module to be in conjunction with the World Health Organization quality of life scale brief version (WHOQOL-BREF). Health Qual Life Outcomes 2017; 15:167. [PMID: 28835235 PMCID: PMC5569515 DOI: 10.1186/s12955-017-0744-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 08/16/2017] [Indexed: 12/26/2022] Open
Abstract
Background Although numerous health-related quality of life (HRQoL) instruments are available for patients with diabetes, the length of these measures may limit their feasibility to routine practice. Also, these measures do not distinguish items for generic and diabetes-specific HRQoL. This study was aimed to develop a diabetes-specific quality of life questionnaire module (DMQoL) to be in conjunction with the World Health Organization Quality of Life scale brief version (WHOQOL-BREF). Methods One hundred seventeen patients with diabetes were enrolled from a medical center in Taiwan. The item content of DMQoL was constructed based on an extensive review of existing HRQoL instruments for diabetes, expert discussions and patient interviews. A series of psychometric tests were conducted to ensure the reliability and validity of DMQoL. The WHOQOL-BREF served as an existing HRQoL measure for construct validity testing. The response scale of DMQoL was adopted from the 5-point Likert scale of WHOQOL-BREF. Results A total of 10 items without ceiling or floor effects were selected from 20 items. Exploratory factor analysis (EFA) with parallel analysis and Rasch analysis concluded that the 10 items were embedded in the same underlying concept. The corrected item-total correlations and factor loadings from EFA were all above 0.4. The internal consistency of the 10 items was satisfactory (Cronbach’s α = 0.84). The DMQoL total score was moderately correlated with that of WHOQOL-BREF (r = 0.48, p < 0.001). The known-group validity showed that patients with HbA1c ≤ 7% had significantly higher mean scores of DMQoL than did those with HbA1c > 8% (3.66 ± 0.47 vs. 3.41 ± 0.53; p = 0.037). Conclusions The DMQoL with only 10 items is developed and it is sensitive to the change of diabetes progression in early phases (e.g., glycemic changes). The combination of WHOQOL-BREF and DMQoL provides a comprehensive picture of overall HRQoL in patients with diabetes and enhance the instrument’s ability to detect clinically meaningful changes in diabetes. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0744-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Tsung-Ying Lee
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Dou-Liou, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huang-Tz Ou
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Department of Pharmacy, National Cheng Kung University Hosiptial , Tainan, Taiwan.
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The Role of Neuroticism and Psychological Flexibility in Chronic Fatigue and Quality of Life in Patients with Type 2 Diabetes. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2017. [DOI: 10.1515/rjdnmd-2017-0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and Aims: The purpose of this study was to identify the role of neuroticism and psychological flexibility (PF) in quality of life (QOL) and chronic fatigue (CF) in patients with Type 2 Diabetes Mellitus (T2DM). Materials and Methods: We considered the all of the patients with T2DM over aged 30 years and living in the province of Hamadan, Iran in 2014 that were referred to the Hamadan Diabetes Center. A sample size of 170 patients was selected by the simple random sampling method. The measuring tools were completed by the patients. To test assumptions, the Pearson correlation and structural equation modeling were used. Results: The results showed that the correlation coefficient between neuroticism, with CF (r=0.579; p<0.001) and QOL (r=-0.242; p<0.001), and also correlation between PF and CF (r=0.287; p<0.001) are significant. There is no significant relationship between QOL and PF (r= -0.098; p=0.203). Structural equation modeling showed that neuroticism has a direct positive effect in CF (p<0.001) and a negative effect on QOL (p<0.001), and the PF has a significant direct effect on CF (p=0.014) and an indirect effect on QOL. The CF affects negatively on the QOL (p<0.001). Conclusion: It could be concluded that neuroticism and PF play important roles in QOL and CF and with effective intervention can help patients with diabetes to improve them QOL.
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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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11
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Paula JS, Braga LD, Moreira RO, Kupfer R. Correlation between parameters of self-monitoring of blood glucose and the perception of health-related quality of life in patients with type 1 diabetes mellitus. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 61:343-347. [PMID: 27901179 PMCID: PMC10118933 DOI: 10.1590/2359-3997000000222] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 08/10/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate how different parameters of short-term glycemic control would correlate with the perception of health-related quality of life (HRQoL) in patients with type 1 diabetes mellitus (T1D). SUBJECTS AND METHODS A total of 50 T1D patients aged 18 to 50 years were evaluated with the questionnaires Problem Areas in Diabetes (PAID) scale and Diabetes Quality of Life (DQOL) measure after 30 days of self-monitoring of blood glucose (SMBG). Glycemic control was evaluated using glycated hemoglobin (HbA1c), mean glucose levels (MGL) in the prior month's data from SMBG (Accu-Check 360o), number of hypoglycemic episodes (< 70 mg/dL and < 50 mg/dL), and glycemic variability (GV). RESULTS PAID correlated positively with MGL (r = 0.52; p < 0.001) and HbA1c (r = 0.36; p < 0.0097), but not with GV (r = 0.17; p = 0.23) or number of hypoglycemic episodes (r = 0.15; p = 0.17 for glucose < 70 mg/dL and r = 0.02; p = 0.85 for glucose < 50 mg/dL). After multiple linear regression, only MGL remained independently related to PAID scores. DQOL scores had a positive correlation with MGL (r = 0.45; p = 0.001), but not with HbA1c (r = 0.23; p = 0.09), GV (r = 0.20; p = 0.16), or number of hypoglycemic episodes (r = 0.06 p = 0.68). CONCLUSION In T1D patients, MGL, but not HbA1c or number hypoglycemic episodes, was the glycemic control parameter that best correlated with short-term perception of HRQoL.
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Affiliation(s)
- Juliana Santos Paula
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
| | - Letícia Dinis Braga
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
| | - Rodrigo Oliveira Moreira
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
| | - Rosane Kupfer
- Serviço de Diabetes, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, RJ, Brasil
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Koekkoek PS, Biessels GJ, Kooistra M, Janssen J, Kappelle LJ, Rutten GEHM. Undiagnosed cognitive impairment, health status and depressive symptoms in patients with type 2 diabetes. J Diabetes Complications 2015; 29:1217-22. [PMID: 26281970 DOI: 10.1016/j.jdiacomp.2015.07.010] [Citation(s) in RCA: 15] [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: 05/02/2015] [Revised: 07/06/2015] [Accepted: 07/12/2015] [Indexed: 11/16/2022]
Abstract
AIMS Type 2 diabetes (T2DM) is associated with cognitive impairment. We examined whether undiagnosed cognitive impairment in T2DM-patients is associated with a reduced health status and depressive symptoms. METHODS In an observational study, 225 T2DM-patients aged ≥70years were examined at their homes and (some of them) at a memory clinic for undiagnosed cognitive impairment (dementia or mild cognitive impairment [MCI], defined according to internationally accepted criteria). Questionnaires assessing health status (SF-36, EQ-5D, EQ-VAS) and depressive symptoms (CES-D) were filled out. Health status and depressive symptoms were compared between patients with and without cognitive impairment. RESULTS Patients with cognitive impairment (n=57) showed significantly lower scores on the physical and mental summary scores of the SF-36 than patients with normal cognition (difference: 3.5 (95%-CI 0.7-6.3, p=0.02, effect size 0.41) and 2.9 (95%-CI 0.3-5.6; p=0.03, effect size 0.37). EQ-5D index and EQ-VAS scores were significantly lower in patients with cognitive impairment. Depression (CES-D≥16) occurred almost twice as often in patients with cognitive impairment (RR 1.8; 95%-CI: 1.1-3.0). CONCLUSIONS Undiagnosed cognitive impairment in T2DM-patients is associated with a reduced health status and more depressive symptoms. Detection of cognitive impairment in T2DM-patients identifies a vulnerable patient group that could benefit from tailored treatment and care.
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Affiliation(s)
- Paula S Koekkoek
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands
| | - Minke Kooistra
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
| | - Jolien Janssen
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
| | - L Jaap Kappelle
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands
| | - Guy E H M Rutten
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
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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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