Effects of metabolic control, patient education and initiation of insulin therapy on the quality of life of patients with type 2 diabetes mellitus

被引：25

作者：

Braun, Anke ^{[1
]}

Saemann, Alexander ^{[2
]}

Kubiak, Thomas ^{[3
]}

Zieschang, Tania ^{[1
]}

Kloos, Christof ^{[2
]}

Mueller, Ulrich Alfons ^{[2
]}

Oster, Peter ^{[1
]}

Wolf, Gunter ^{[2
]}

Schiel, Ralf ^{[4
]}

机构：

[1] Heidelberg Univ, Bethanien Hosp, Dept Geriatr, Heidelberg, Germany

[2] Univ Jena, Dept Internal Med 3, Jena, Germany

[3] Ernst Moritz Arndt Univ Greifswald, Inst Psychol, Greifswald, Germany

[4] Inselklin Heringsdorf, Heringsdorf, Germany

来源：

PATIENT EDUCATION AND COUNSELING | 2008年 / 73卷 / 01期

关键词：

type 2 diabetes mellitus; treatment and teaching program; education; quality of life; hypoglycaemia; insulin therapy;

D O I：

10.1016/j.pec.2008.05.005

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Objective: The objective of this study was to evaluate the impact of initiation of insulin therapy, metabolic control and structured patient education on the diabetes-related quality of life (QoL) in insulin-treated patients with type 2 diabetes mellitus. Methods: This prospective study was conducted with 71 consecutively recruited patients with insulin-treated diabetes at the University hospital. All patients participated an inpatient diabetes treatment and teaching program (DTTP) for conventional insulin therapy (mean age 68.9 years, HbAlc 10.1 +/- 1.4%, diabetes duration 11.2 years (range: 0-25.5 years), body-mass-inclex 28.7 +/- 5.7 kg/m(2). Diabetes-related quality of life was assessed before and 6 months after participation in the DTTP using the standardized questionnaire of Lohr analysing the subscales: social relations, physical complaints, worries about the future, dietary restrictions, fear of hypoglycaemia, and daily struggles. Results: Only patients switched on insulin therapy showed significant improvement in diabetes-related quality of life 6 months after participation in the DTTP (p = 0.03), fewer physical complaints (p = 0.03), fewer worries about the future (p = 0.02), fewer daily struggles (p = 0.01) and less fear of hypoglycaemia (p < 0.001), while patients, who were already on insulin therapy showed no improvements in diabetes-related quality of life. Though, residual analysis reveals that effects on patients' QoL are mainly caused by improvements in metabolic control. Conclusions: Improvements in metabolic control have a significant effect on different diabetes-related quality of life domains in patients with diabetes mellitus. Practice implications: Appropriate interventions resulting in better metabolic control. such as starting oil insulin therapy within a structured patient education program seem to be an effective approach to improve patients' diabetes-related quality of life. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

引用

页码：50 / 59

页数：10

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