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Well-Being and Treatment Satisfaction in Older People With Diabetes

  1. Tim Petterson, MRCP,
  2. Pauline Lee, DIPNS,
  3. Sally Hollis, MSC,
  4. Bob Young, FRCP,
  5. Peggy Newton, PHD and
  6. Tim Dornan, FRCP
  1. Departments of Geriatric Medicine, Hope Hospital Salford, Manchester
  2. Diabetes and Endocrinology, Hope Hospital Salford, Manchester
  3. Computation and Statistics, Hope Hospital Salford, Manchester
  4. Department of General Practice, Community Sciences Centre, Northern General Hospital Sheffield, U.K.
  1. Address correspondence and reprint requests to Dr. Tim Dornan, Consultant Physician, Hope Hospital, Stott Lane, Salford, Manchester M6 8HD, U.K. E-mail: tdornan{at}fsl.ho.man.ac.uk

Abstract

OBJECTIVE To measure well-being and treatment satisfaction and their correlates in older people with diabetes.

RESEARCH DESIGN AND METHODS A postal survey was conducted of 1,000 diabetic patients aged ≥ 60 years, representing 56% of the resident older diabetic population in an inner-city health district with a largely indigenous population of 230,000 people and a widely varied socioeconomic mix. Well-being and treatment satisfaction were measured with diabetes-specific instruments and correlated with patient data held in a central register.

RESULTS There was an 81% response. The general well-being scores (median [interquartile range]) for patients on diet alone, tablets, and insulin were 54 (44–60), 53 (42–61), and 48 (35–56) (P < 0.001 comparing insulin with diet and tablets) compared with a scale maximum of 66. Treatment satisfaction scores were 35 (31–36), 35 (32–36), and 34 (30–36) (P < 0.001 comparing insulin with diet and tablets), scale maximum 36. Mean HbA1c concentrations were 5.0 ± 1.4% (for patients on diet alone), 5.8 ± 1.6% (tablets), and 6.6 ± 1.7% (insulin) (P < 0.001 for each difference). Neither well-being nor treatment satisfaction correlated with HbA1c. Insulin-treated patients were younger and had been diabetic longer than non-insulin-treated patients; their well-being remained slightly, but significantly, lower when adjusted for age, sex, BMI, and diabetes duration, but treatment satisfaction was no longer significantly different. Women had lower well-being than men.

CONCLUSIONS It has proved possible to measure well-being and treatment satisfaction in a large community-based samples of older people with diabetes. At the level of glycemic control in this population, neither parameter correlated with HbA1c. The lower well-being in insulin-treated patients remained significant in multivariate analysis.

  • Received October 27, 1997.
  • Accepted February 9, 1998.
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