Endocrine Abstracts

Introduction: Diabetes is a disease with great psychosocial impact and reduced quality of life (QoL), and psychosocial factors seem to be excellent predictors of clinical outcomes.

Objective: Assess the relationship between the patient’s perception of diabetes management and its impact on QoL.

Methods: Interview of patients with type 1 (T1D) and type 2 diabetes (T2D), using the ‘Appraisal of Diabetes Scale’ (ADS), a questionnaire composed of 7 items that are summed to reflect the patients’ self-appreciation of their diabetes. A 0 score indicates good management, with minimal impact on QoL and 35 a worse management and a negative impact on QoL. Analysis of the association between the ADS result and the following factors: type of treatment, duration and control of diabetes, chronic complications (assessment of the number and severity using the ‘Diabetes Complications Severity Index’ (DCSI)), daily number of blood glucose measurements and number of consultations in the last year.

Results: 165 patients, 86.2% male, mean age 65 +/- 11 years, 92.1% with T2D and 7.9% with T1D, with a mean duration of 13.5 +/- 10.5 years. 64.8% of patients were on oral antidiabetic drugs (OAD), 5.5% on daily injectable GLP-1 agonists (aGLP-1), 14.5% on basal insulin and 15.2% on basal-bolus insulin regimen. The mean HbA1c was 7.1 +/- 1.4% and the DSCI result was 2 +/- 2, corresponding to 1 +/- 1.2 complications per patient. Daily glycaemia measurements were on average 1+/-2 and the average medical visits per year was 3.5 +/- 1.7. The ADS result was 16 +/- 4 in the OAD and aGLP-1 groups, 18 +/- 4 in the basal insulin group, and 19 +/- 5 in the basal-bolus insulin group, with a significant difference between groups (P=0.018). Higher HbA1c values correlated with worse ADS results (P=0.009), but the same was not observed with the number and severity of diabetic complications (DSCI) (P=0.58), nor with the duration of diabetes (P=0.5). A greater number of daily blood glucose measurements and annual medical visits correlated with worse results in the ADS (P=0.02 andP=0.03).

Discussion: The results demonstrate that patients’ perception of diabetes management was adequate for their actual control and that the introduction of insulin regimens or stricter follow-up (greater number of blood glucose tests or consultations per year) are correlated with worse QoL. However, the impact of diabetic complications is undervalued by patients, which reinforces the need to raise awareness about them.