Low-income patients who perceive more control over their diabetes have higher quality of life
Patients with diabetes must maintain strict control of their blood-sugar levels through diet, exercise, and medication. Indigent patients treated for diabetes at a low-income clinic who perceived they had more control over their diabetes reported higher quality of life, according to a new study. Over the course of a year, researchers gave questionnaires to 188 patients with diabetes who received care at a low-income clinic that was part of a major academic medical center. The questionnaires asked about patients’ perceived control of diabetes and health-related quality of life. The researchers also collected sociodemographic and clinical information, including patient race/ethnicity, marital and socioeconomic status, coexisting conditions, and insulin use.
More than half of participants (54 percent) were 50 to 64 years of age. The vast majority were female (71 percent) and 60 percent were black. Just under a quarter of participants (24 percent) were uninsured, with 54 percent covered by a government program such as Medicaid. The majority, 60 percent, did not use insulin. Average quality-of-life scores were below national averages for the general population. However, there was a direct, positive association found between a patient’s perceived control over diabetes and their physical and mental quality of life. This relationship continued to be strong even after the researchers controlled for patient sociodemographic factors and number of coexisting conditions. The researchers suggest that clinicians can use assessments of perceived control to design specific approaches that empower patients to manage their diabetes by increasing their knowledge base and enhancing their self-efficacy which, in turn, will increase perceived control. The study was supported by the Agency for Healthcare Research and Quality (HS11418).
See "Effect of perceived control on quality of life in indigent adults with type 2 diabetes," by Melba A. Hernandez-Tejada, M.S., Cheryl P. Lynch, M.D., M.P.H., Joni L. Strom, M.D., M.P.H., and Leonard E. Egede, M.D., M.S., in the March/April 2012 The Diabetes Educator 38(2), pp. 256-261.