Living with Diabetes: Relationship to Gender, Duration and Complications. A Survey in Northern Sweden

Abstract

A questionnaire was sent to 561 insulin-treated diabetic patients aged 20-50 years living in the province of Västerbotten in Northern Sweden to assess their experience of living with diabetes. The response rate was 87% (n = 488). Differences in the experience of living with diabetes related to gender, age, duration of diabetes, and chronic diabetic complications were reported. Men seemed to underestimate problems related to diabetes more than women. They worried less about long-term complications and hypoglycaemia, but were more troubled by the limitation of personal freedom caused by their diabetes. In spite of their worries, women more often than men found positive aspects in having diabetes. Younger patients also had a more positive attitude towards their disease, even though they more often thought that diabetes had negatively affected their relationships with friends. Patients with a shorter diabetes duration were more concerned about the management of their diabetes than were patients with a long duration. The fear of chronic complications increased with diabetes duration. Chronic complications most affected patients' views of diabetes, their self-perception, and social life. Patients with childhood onset of diabetes knew less about the implications of the disease, and this reduced the intensity of their psychological response to the diagnosis. In conclusion, social and medical factors affected how diabetic patients perceived their disease. These findings suggest that the outcome of diabetes health care might improve if it was more individually adapted to each patient's personal experience of the disease and the psychological needs related to it.

The impact of gender on the long-term morbidity and mortality of patients with type 2 diabetes receiving structured personal care: a 13 year follow-up study

“…Men have been found to be less worried about long-term outcomes and to be more troubled by limitations to their personal freedom following diabetes diagnosis [34]. Men expect less benefit from selfmanagement [34] and rely more on self-directed learning [8]. This may contribute to the poorer outcome among men in the structured diabetes intervention.…”

“…Women accept disease and implement disease management more easily [13], which might affect long-term outcomes. Masculinity may be challenged by diabetes, demanding daily consideration and lifestyle changes [34]. The structured approach could conflict with men's tendency to trust self-directed learning instead of self-management.…”

“…We previously reported a more adaptive attitude towards treatment among women, and this could lead to better treatment adherence and disease outcomes [13]. Women report poorer social support compared with men [34], possibly linked to a poorer self-perceived quality of life [35]. This, together with health status, is related to increased mortality [36].…”

“…Negotiating work and healthcare have been identified as barriers to disease selfmanagement and acceptance of disease [38]. Men have been found to be less worried about long-term outcomes and to be more troubled by limitations to their personal freedom following diabetes diagnosis [34]. Men expect less benefit from selfmanagement [34] and rely more on self-directed learning [8].…”

Effect of Diabetes Mellitus on Quality of Life: A Review

“…However, a somewhat unexpected finding 33 was that fewer than 10% of the patients with complications regarded themselves as unwell. Self-reported health has been suggested to play an important role in the adherence to diabetes management and metabolic control, and also to be important for diabetic patients' symptoms, use of health care, and their satisfaction with the doctor-patient relationship.…”