Quality of life of patients with type 2 diabetes in relation to method of treatment

Abstract

Inappropriate glycaemic control in type 2 diabetes leads to long-term complication and affects length of life. Intensification of treatment, involving insulin therapy is often delayed because of fear of negative influence on quality of life (QoL). Aims: evaluation of differences on QoL with type 2 diabetes patients in relation to method of current antidiabetic treatment, especially patients who are on the threshold of insulin therapy introduction. Methods: study involved 274 patients (mean 62.2years, 55.8%F) who were divided into 3 groups: patients treated with oral anti-diabetic agents (OAD group, n=111), patients, for whom insulin was introduced (Intensification group, n=68) and patients treated with insulin (Insulin group, n=95). QoL was measured with questionnaires: EQ-5D, DQL-BCI and DSC-R. Results: There were no statistically significant differences in EQ-5D indices among studied patients (OAD group-0.82, Intensification group–0.78, Insulin group–0.75). EQ-VAS among patients switched to insulin therapy was lower than in OAD group (52.7 and 59.3, respectively, p=0.004). The differences in DQL-BCI scores among all groups of patients were statistically insignificant (scores: OAD group-56.7, Intensification group-54.8, Insulin group-51.7). DSC-R score in Intensification group was higher than among OAD group (30.9 and 25.3, respectively, p=0,08). Patients switched to insulin therapy manifested the highest level of hyperglycemia-related burden and the lowest treatment satisfaction. Conclusions: patients whose treatment was intensified reported their QoL as lower than the patients treated with OAD, however there was no significant difference found in respect of QoL between patients from the latter group and patients already treated with insulin.