Health perceptions of diabetic patients in the REDIA study

• Published in: Diabetes & metabolism 2006-02, Vol.32 (1), p.50-55
• Main Authors: Debussche, X, Roddier, M, Fianu, A, Le Moullec, N, Papoz, L, Favier, F
• Format: Article
• Language: English
• Subjects: Adult; Aged; Attitude to Health; Biological and medical sciences; Chronic diseases; Connaissances; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - rehabilitation; Diabetes. Impaired glucose tolerance; Diabète sucré; Diet, Diabetic; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; France - epidemiology; Geography; Health perceptions; Humans; Knowledge; Maladies chroniques; Male; Medical sciences; Middle Aged; Perceptions de santé; Prevalence; REDIA study; Risk Factors; Surveys and Questionnaires; Étude REDIA
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/S1262-3636(07)70246-X

To explore the beliefs and perceptions of type 2 diabetic patients in La Réunion where the disease is highly prevalent (17.5% among 30-69 yr old subjects) with a strong link to the metabolic syndrome and nutritional habits. Two sets of data were analysed. An 80-item questionnaire explored the perceptions of causal factors, knowledge of complications and therapeutic issues in 331 known diabetic patients included in the REDIA study. The data were completed by semi-structured interviews of 40 diabetic patients in a hospital setting. Perceived causal factors of diabetes are mainly sugar excess, heredity and stress or life events. Weight excess and lack of physical activity are virtually never mentioned as causes. Diabetes is predominantly perceived as potentially acute, with risk of coma and death. Its chronic and progressive nature is not appreciated, and chronic complications are not well understood, especially in poorly educated people. Only 33% of males and 42% of females are willing to change their nutritional habits and the role of fats is largely underestimated (30.2%) although 90% consider physical activity as an effective course of action. Most patients are tardy in the way that they adopt medical recommendations and treatment in the course of the disease. These results highlight the discrepancy between medical knowledge and patients' perceptions, especially concerning etiological issues and complications. Lifestyle and therapeutic recommendations are not well understood. Educational activities need to consider the knowledge issues and understanding by patients early in the course of chronic diseases like diabetes. Perceptions de santé des patients diabétiques : l'étude REDIA Explorer les perceptions des patients diabétiques de type 2 à la Réunion, dans un contexte de prévalence élevée (17,5 % chez les 30-69 ans) avec une liaison forte au syndrome métabolique et aux pratiques alimentaires. Deux sources de données sont analysées: 331 questionnaires (80 items: causes, conséquences et traitement du diabète) soumis aux patients diabétiques connus de l'étude REDIA et 40 entretiens semi-directifs auprès de patients diabétiques hospitalisés. Les causes rapportées les plus fréquentes sont l'excès de sucre, l'hérédité, et le « stress » ou événements de vie. Le surpoids et l'inactivité ne sont pratiquement pas mis en cause. Le diabète est perçu avant tout comme une maladie menaçante avec risque de coma et de mort. Sa nature chronique n'est pas mise en avant. Le