Well-Being and Treatment Satisfaction in Older People With Diabetes

Petterson, T; Lee, Pauline; Hollis, Sally; Young, Bob; Newton, Peggy; Dornan, Tim

doi:10.2337/diacare.21.6.930

Cited by 109 publications

(77 citation statements)

References 13 publications

(27 reference statements)

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“…Our results are consistent with other studies that have demonstrated lower health-utility scores in women with diabetes [6,[31][32][33] and worse QoL in the presence of complications [6,20,33,34]. However, even with inclusion of gender and diabetic complications in the model, frequency of hyperglycemic symptoms was associated with lower health-utility scores.…”

Section: Discussionsupporting

confidence: 92%

Glycemia and the Quality of Well-Being in Patients with Diabetes

et al. 2004

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Objectives: To investigate the cross-sectional relationships among self-reported frequencies of symptomatic hyperglycemia and hypoglycemia, HbA1c, and symptoms in the Quality of Well-Being Self-Administered (QWB-SA), and to examine the associations among these measures of glycemia and health-utility scores. Methods: The study group included 1522 patients with diabetes who attended University of Michigan Health System clinics. Published studies were reviewed to identify symptoms in the QWB-SA that might be associated with measures of glycemia. Linear-regression analyses were performed to evaluate the strength of the associations among the frequency of self-reported measures of glycemia, QWB-SA symptoms, and QWB-SA-derived health-utility scores. Results: Frequency of hyperglycemic symptoms was associated with 3% of the variance in the QWB-SA-derived health-utility score in type-1 diabetes and with 5% of the variance in type-2 diabetes. Frequency of hypoglycemic symptoms was not associated with the QWB-SAderived health-utility score in type-1 diabetes but was associated with 1% of the variance in type-2 diabetes. HbA1c levels were not significantly associated with QWB-SA-derived health-utility scores. After controlling for age, gender, and complications, frequency of hyperglycemic symptoms was significantly associated with QWB-SA-derived health-utility scores in type-1 and type-2 diabetes. Conclusions: Reported frequency of hyperglycemic symptoms is associated with symptoms included in the QWB-SA and with QWB-SAderived health-utility scores. The QWB-SA may be an appropriate measure to assess the health burden of hyperglycemia.

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Section: Discussionsupporting

confidence: 92%

Glycemia and the Quality of Well-Being in Patients with Diabetes

et al. 2004

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“…In diabetic populations, 2.0 to about 2.5 points is a reasonable estimate of the smallest clinically important difference in either physical or mental component summary scores [17]. The validity of the SF-36 has been demonstrated in several studies of diabetic participants [14,[18][19][20][21][22].…”

Section: Methodsmentioning

confidence: 99%

Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial

et al. 2009

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Aims/hypothesis The Diabetes Aerobic and Resistance Exercise (DARE) study showed that aerobic and resistance exercise training each improved glycaemic control and that a combination of both was superior to either type alone in patients with type 2 diabetes mellitus. Here we report effects on patient-reported health status and well-being in the DARE Trial. Methods We randomised 218 inactive participants with type 2 diabetes mellitus in parallel to 22 weeks of aerobic exercise (n=51), resistance exercise (n=58), combined aerobic and resistance exercise (n=57) or no exercise (control; n=52). Intervention allocation was managed by a central office. Outcomes included health status as assessed by the physical and mental component scores of the Medical Outcomes Trust Short-Form 36-item version (SF-36) and well-being as measured by the Well-Being Questionnaire 12-item version (WBQ-12); these were measured at the Ottawa Hospital. Results Using a p value of 0.0125 for statistical significance due to multiple comparisons, mixed model analyses indicated that resistance exercise led to clinically but not statistically significant improvements in the SF-36 physical component score compared with aerobic exercise (Δ=2.7 points; p=0.048) and control (i.e. no exercise; Δ=3.3 points; p=0.015). For mental component scores, there were clinically important improvements favouring no (control) compared with resistance (Δ=7.6 points; p<0.001) and combined (Δ=7.2 points; p<0.001) exercise. No effects on WBQ-12 scores were noted. Overall, 59/218 (27%) of participants included in this analysis sustained an adverse event during the course of the study, including 16 participants in the combined exercise group, 19 participants in the resistance exercise group, 16 participants in the Electronic supplementary material The online version of this article

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“…However, others have found lower treatment satisfaction in patients taking insulin. 30 Although the advantages of better metabolic control in patients with type 2 diabetes have been advocated for a long time, in particular for patients aged 40-55 years, 31,32 this has recently been challenged by a study showing that intensive glucose therapy may be beneficial only in patients aged 65 or fewer years. 33 The clinical decision to initiate insulin requires that the benefits should outweigh the risks.…”

Section: Limitationsmentioning

confidence: 99%

Initiation of insulin therapy in elderly patients taking oral antidiabetes drugs

Pérez¹,

Moisan²,

Sirois³

et al. 2009

Canadian Medical Association Journal

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Methods Data sourcesUsing the database of the Quebec health insurance board (La Régie de l'assurance maladie du Québec) and the Quebec registry of hospital admissions (Maintenance et exploitation des données pour l'étude de la clientèle hospitalière [MedEcho]), we performed a population-based inception cohort study. The health insurance plan of Régie de l'assurance maladie du Québec covers all permanent residents of the province for both medical services and hospital admissions. Its public drug plan covers recipients of welfare, those not eligible for a private group plan for drug insurance and all people aged 65 years and over who do not live in an institution. This drug-plan database is accurate for prescription claims.12 In 2006, a total of 3.2 million people (out of a population of 7.5 million) were beneficiaries of this drug plan.A unique encrypted health number was used to link the databases and the registry at the patient level. Initiation of insulin therapy in elderly patients taking oral antidiabetes drugsFrom the Unité de recherche en santé des populations (Pérez, Moisan, Sirois, Grégoire), Centre de recherche du centre hospitalier affilié universitaire de Québec; the Faculty of Pharmacy (Moisan, Sirois, Poirier, Grégoire), Université Laval, and the Quebec Heart and Lung Institute (Poirier), Hôpital Laval, Québec, Que. Background:We sought to estimate the rate of initiation of insulin therapy among elderly patients using oral antidiabetes drugs and to identify the factors associated with this initiation. Methods:We conducted a population-based cohort study involving people aged 66 or more years who were newly dispensed an oral antidiabetes drug. Individuals who had received acarbose or a thiazolidinedione were excluded. The rate of insulin initiation was calculated by use of the KaplanMeier method. Factors associated with insulin initiation were identified by multivariable Cox regression analyses. Results:In this cohort of 69 674 new users of oral antidiabetes drugs, insulin was initiated at rate of 9.7 cases per 1000 patient-years. Patients who had initially received an insulin secretagogue (rather than metformin), who were prescribed an oral antidiabetes drug by an endocrinologist or an internist, who received higher initial doses of an oral antidiabetes drug, who received oral corticosteroids, used glucometer strips, or were admitted to hospital in the year before initiation of oral antidiabetes therapy, or who received 16 or more medications were more likely than those without these characteristics to have insulin therapy initiated. In contrast, patients who received thiazides or who used up to 12 medications (v. none) were less likely to have insulin therapy initiated.Interpretation: Several factors related to drugs and health services are associated with the initiation of insulin therapy in elderly patients receiving oral antidiabetes drugs. It is unclear whether these factors predict secondary failure of oral antidiabetes drugs or instead reflect better management of type 2 diabetes.

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Well-Being and Treatment Satisfaction in Older People With Diabetes

Cited by 109 publications

References 13 publications

Glycemia and the Quality of Well-Being in Patients with Diabetes

Glycemia and the Quality of Well-Being in Patients with Diabetes

Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial

Initiation of insulin therapy in elderly patients taking oral antidiabetes drugs

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