Determinants of health status in patients with diabetes: clues to how we should target management

Lawlor, Janine, Hird, K., Corkhill, L., Joseph, A., Malabu, U.H., and Kennedy, R.L. (2010) Determinants of health status in patients with diabetes: clues to how we should target management. Annals of the Australasian College of Tropical Medicine, 11 (2). p. 69.

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There are frequently differences between patients' expectations, and what health professionals aim to achieve. With increasing focus on cardiovascular risk factor targets, we do not always address the patient's immediate problems. We used the SF-36 questionnaire to investigate relationship between various health dimensions and clinical factors. 218 consecutive diabetic patients were studied – 106 women and 112 men, mean age 53.6 years. 35 had type 1 diabetes, 121 type 2, and 62 type insulin-requiring (T2INS ). Physical health (rated 0 to 100) was 62.2 for type 1, 56.0 for type 2 (NS), and 43.5 for T2INS (p<0.001). S cores for mental health were 65.7, 59.9 (NS), and 51.3 (p<0.001). Poor health of T2INS ranged across all eight dimensions including pain, vitality and social function. 183 patients with type 2 were divided into tertiles according to BMI. Physical health scores were 59.5, 54.8, and 41.0 (lowest to highest BMI, p<0.001, ANOVA). Scores for mental health were 61.7, 58.2, and 51.1 (p<0.05, ANOVA). Dividing patients into tertiles according to physical health (1=poorest), age, H bA1c, and CRP did not differ while BMI did (38.0, 34.2, 32.7 – p<0.001). Age was not a determinant of mental health, while HbA1c (9.4, 9.1, 8.1 – p<0.01), CRP (15.3, 8.1, and 6.0 – p<0.02), and BMI (36.5, 35.3, and 33.0 – p<0.05) were. Metabolic control, frequently the focus for management, is not the major determinant of how patients feel. Addressing problems related to excess body weight might help to improve physical health. Metabolic factors and low-grade inflammation.

Item ID: 18881
Item Type: Article (Abstract)
ISSN: 1448-4706
Date Deposited: 10 Oct 2011 02:48
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 100%
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