Diabetes Metab J.  2020 Feb;44(1):91-102. 10.4093/dmj.2018.0251.

Changes in the Quality of Life in Patients with Type 2 Diabetes Mellitus According to Physician and Patient Behaviors

• Kim YJ
• Jeong IK
• Kim SG
• Cho DH
• Kim CH
• Kim CS
• Lee WY
• Won KC
• Cha JH
• Lee J
• Kim DM

• KMID: 2470958
• DOI: http://doi.org/10.4093/dmj.2018.0251

Abstract

BACKGROUND
Diabetes mellitus (DM) is the most common chronic metabolic disorder with an increasing prevalence worldwide. According to a previous study, physicians' treatment patterns or patients' behaviors change when they become aware of the risk for cardiovascular (CV) disease in patients with DM. However, there exist controversial reports from previous studies in the impact of physicians' behaviors on the patients' quality of life (QoL) improvements. So we investigate the changes in QoL according to physicians and patients' behavioral changes after the awareness of CV risks in patients with type 2 DM.
METHODS
Data were obtained from a prospective, observational study where 799 patients aged ≥40 years with type 2 DM were recruited at 24 tertiary hospitals in Korea. Changes in physicians' behaviors were defined as changes in the dose/type of antihypertensive, lipid-lowering, and anti-platelet therapies within 6-month after the awareness of CV risks in patients. Changes in patients' behaviors were based on lifestyle modifications. Audit of Diabetes Dependent Quality of Life comprising 19-life-domains was used.
RESULTS
The weighted impact score change for local or long-distance journey (P=0.0049), holidays (P=0.0364), and physical health (P=0.0451) domains significantly differed between the two groups; patients whose physician's behaviors changed showed greater improvement than those whose physician's behaviors did not change.
CONCLUSION
This study demonstrates that changes in physicians' behaviors, as a result of perceiving CV risks, improve QoL in some domains of life in DM patients. Physicians should recognize the importance of understanding CV risks and implement appropriate management.

Keyword

Cardiovascular diseases; Diabetes mellitus; Risk management; Quality of life

MeSH Terms

Cardiovascular Diseases
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Holidays
Humans
Korea
Life Style
Observational Study
Prevalence
Prospective Studies
Quality of Life*
Risk Management
Tertiary Care Centers

Figure

• 

  Fig. 1 Korean version of the Audit of Diabetes Dependent Quality of Life (K-ADDQoL) score at baseline and follow-up. (A) Impact score at baseline and follow-up. Impact score range is −3 to +3 (−3: more impact, +3: less impact). (B) Importance score at baseline and follow-up. Importance score range is +3 to 0 (+3: more importance, 0: less importance). (C) Weighted impact score at baseline and follow-up. Weighted impact score range is −9 to +3 (−9: more impact, +3: less impact). AWI, average weighted impact. aP value are less than 0.05 (P<0.05).

• 

  Fig. 2 Change of Korean version of the Audit of Diabetes Dependent Quality of Life (K-ADDQoL) by physician behavior change. (A) Change of impact score by physician behavior change. Change of impact score is from follow-up to baseline. (B) Change of importance score by physician behavior change. Change of importance score is from follow-up to baseline. (C) Change of weighted impact (WI) score by physician behavior change. Change of WI score is from follow-up to baseline. AWI, average weighted impact. aP value by t-test are less than 0.05 (P<0.05).

• 

  Fig. 3 Change of Korean version of the Audit of Diabetes Dependent Quality of Life (K-ADDQoL) by patients behavior change. (A) Change of Impact score by patients behavior change. Change of impact score is from follow-up to baseline. (B) Change of Importance score by patients behavior change. Change of importance score is from follow-up to baseline. (C) Change of weighted impact (WI) score by patients behavior change. Change of WI score is from follow-up to baseline. AWI, average weighted impact. aP value by t-test are less than 0.05 (P<0.05).

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