Сахарный диабет (Dec 2010)
Quality of life in young patients with type 1 diabetes mellitus
Abstract
Aim. To study quality of life (QL) in young patients with type 1 diabetes mellitus (DM1) depending on clinical characteristics, diabetes-related behaviour,and demographic indices. Materials and methods. The study included 89 patients (25 men aged 18-28 years) with DM1. Exclusion criteria were newly diagnosed DM, terminalstages of diabetic complications, severe concomitant somatic and psychic diseases. The patients filled the socio-demographic questionnaire, theirHbA1c was measured. QL was estimated using the Audit of Diabetes Dependent Quality of Life (ADDQoL) questionnaire and general well-beingbased on the Well-Being Questionnaire 12 (W-BQ12). In addition, the frequency of glycemia self-control was determined as an aspect of the diabetes-related behaviour. Results. Mean age of the patients was 22.3?3.0 years, mean duration of DM 9.6?5.8 years, mean HbA1c level 9.7?2.4%. It was shown that CD1has negative effect on all QL aspects (integrated significance of effect based on all scales -1.8). The most seriously affected aspects were dietaryfreedom (-2.9), professional and physical activities (-2.9 and -2.8 respectively), feeling secure about the future (-2.6). ADDQoL did not reveal a relationshipbetween any of these aspects and the HbA1c level. However, results of W-BQ12 suggest a rise in HbA1c associated with the high frequencyof negative emotions (r=-0.242, p = 0.023) and the low level of general emotional well-being (r=-0.253, p=0.019). Progressive diabetic nephropathyhad negative effect on professional activity (r=-0.317, p=0.025), financial well-being (r=-0.242, p=0.025), ability to move over a distance (r=-0.215,r=0.046), and ability to do something (r=-0.295, p=0.006). The highest QL level was documented in the patients who controlled glycemia 1-2 timesa week (mean over all scales -1.2). Lower or high frequencies of self-control were associated with the general worsening of QL (-2.3 and -2.1 respectively,p=0.005). The highest level of emotional well-being was revealed in the patients who controlled glycemia 1-2 times a week (24.7 W-Q12scores). A higher or lower frequency of self-control was associated with deterioration of emotional well-being (22.5 and 20.5 points respectively,p=0.019). ADDQoL data suggest sex-related differences in QL. In women, DM1 had stronger negative effect on the quality of domestic life (-3.2 comparedwith -2.2 in men, p=0.001), social life (-2.5 and -0.9, p=0.021) and dietary freedom (-3.4 and -1.8, p=0.007). Moreover, women experiencedstronger diabetes-related negative emotions than men (4.1 vs 2.5 points, p=0.007, W-B12).Сахарный диабет Обучение и психосоциальные аспекты44 4/2010Conclusion. DM1 has negative effect on all QL aspects. Dietary freedom, professional and physical activities, feeling secure about the future are moststrongly affected. The most important factors through which these effects are mediated include clinical characteristics (quality of compensation ofcarbohydrate metabolism, diabetic complications), DM-related behaviour (frequency of glycemia self-control), and gender.
Keywords
