What are disease perceptions and subjective treatment goals of insulin treated diabetic patients?

• Published in: Swiss medical weekly 2005-06, Vol.135 (25-26), p.365-371
• Main Authors: Puder, Jardena J, Lächelt, Stephan, Endrass, Jerôme, Müller, Beat, Keller, Ulrich
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Glucose - analysis; Blood Glucose Self-Monitoring; Diabetes Complications - epidemiology; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - psychology; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - psychology; Diet; Female; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Insulin - administration & dosage; Insulin - therapeutic use; Insulin Infusion Systems; Male; Middle Aged; Motor Activity; Physician-Patient Relations; Quality of Life; Weight Loss
• ISSN: 1424-7860

Despite increasing importance of patient self-management, little is known about their own perceptions and treatment goals. The aim of this explorative study was to examine what diabetic patients perceive as most concerning and what their own treatment goals are. A 23-item anonymous questionnaire was distributed among type 1 diabetic patients treated with and without an insulin pump and insulin treated type 2 diabetic patients in the outpatient clinic of a University Hospital. 86% of the questionnaires were returned (n = 124). In open-ended questions, patients in all three groups together felt mostly restricted by their loss of freedom (24%), the dietary restrictions (17%) and the need to measure blood glucose (17%). Patients treated with an insulin pump worried more about hypoglycaemia and less about dietary restrictions. In closed-ended questions, patients were mostly concerned about hypoglycaemia and developing complications. However, the main treatment goal of both groups together was long-term good blood glucose control (63%). Further patient goals were the prevention of complications (27%) and the preservation of a good quality of life. Quality of life was a more important goal for type 1 diabetic patients (29%) than for type 2 diabetic patients (0%). Patients thought that blood glucose control was more important for their physicians (main treatment goal for 86%) than for themselves. Insulin treated patients with diabetes spontaneously express concerns about their actual quality of life and daily hassles and mention long-term worries after explicit questioning. For their main treatment goals they choose mainly long-term goals. According to the patients, physicians tend to overestimate blood glucose control.