Impact of Diabetes Screening on Quality of Life

Abstract

OBJECTIVE -Diagnosis of a chronic illness can have a negative impact on patients' perception of their well-being ("labeling" effect). We sought to determine the effects of a new diagnosis of diabetes, discovered by systematic screening, on patients' health-related quality of life (HRQoL) 1 year after diagnosis.RESEARCH DESIGN AND METHODS -We performed diabetes screening at the Durham Veterans Affairs Medical Center of 1,253 outpatients, aged 45-64 years, who did not report having diabetes. Our initial screen was a serum HbA 1c measurement. All subjects with HbA 1c Ն6.0% were invited for follow-up measurement of blood pressure and fasting plasma glucose. A case of unrecognized diabetes was defined as HbA 1c Ն7.0% or fasting plasma glucose Ն7 mmol/dl. HRQoL was measured by Medical Outcomes Study Short Form 36 (SF-36) for all patients at baseline and 1 year after enrollment. Linear multivariable models were used to determine the independent effect of the new diagnosis of diabetes on HRQoL.RESULTS -Mean SF-36 Physical Component Score (PCS) for all patients was 36.2, and mean Mental Component Score (MCS) was 49.6. A total of 56 patients (4.5%) were found to have diabetes at screening. Patients found to have diabetes at screening had mean PCS of 35.6, which was not different from a mean PCS of 36.3 for those patients found not to have diabetes (P ϭ 0.67). After adjusting for baseline PCS values, PCS 1 year after screening was similar for patients with and without diabetes found at screening (P ϭ 0.95). Similarly, patients found to have diabetes at screening had mean MCS of 48.8; those found not to have diabetes had MCS of 49.6 (P ϭ 0.70). After adjusting for baseline MCS values, MCS 1 year after screening was also similar between the two groups (P ϭ 0.77).CONCLUSIONS -For patients with a new diagnosis of diabetes discovered through systematic screening, HRQoL is similar to patients found not to have diabetes. Furthermore, HRQoL scores remain stable over the year after screening. This suggests that screening for diabetes has minimal, if any, "labeling" effect with respect to HRQoL.

Screening for type 2 diabetes: literature review and economic modelling

“…This assumes that a negative screening test or a positive screening test followed by a negative diagnostic test does not have any clinically significant long-term consequences, although screening itself will potentially have an impact on both quality of life (by provoking anxiety or reassurance) and risk behaviour (due to individuals becomes more or less motivated to change their diet or lifestyle) depending on the context of screening (these issues are well described in papers by Speight 223 and Edelman and colleagues 224 ). It is assumed that these effects can be modified by providing appropriate information and support at the time of screening and have not been included in the modelling.…”

Type 2 Diabetes Mellitus in Family Practice: Prevention and Screening

“…Recently, studies in Europe and the USA have specifically explored the psychological effects of undergoing screening for Type 2 Diabetes and these tend to support the conclusions of Marteau's work. Some studies have assessed the impact of screening by asking patients to complete rating scales that measure their levels of anxiety, depression, and disease-specific worry (Eborall et al, 2007a;Park et al, 2008), or their health-related quality of life (Edelman et al, 2002b). Such studies have generally found no lasting or significant adverse psychological effects in terms of anxiety, depression, worry, or perceived quality of life after screening.…”

Instrumentos de avaliação de qualidade de vida relacionada à saúde no diabetes melito

“…Apesar disso, existe consenso: o DM impacta na QV (17). Estudos demonstram que pacientes com DM têm nível de QV menor do que os pacientes sem esta enfermidade (18). Neste possível impacto negativo da DM sobre a QV, os aspectos que estão envolvidos ainda não são claramente conhecidos (19).…”