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    Diabetes Treatment a Burden to Many

    Insulin Injections Cause Most Distress
    WebMD Health News
    Reviewed by Louise Chang, MD

    Sept. 27, 2007 - Diabetes is now largely manageable, thanks to today’s treatments. But while these treatments keep patients healthy, some perceive them to be almost as bad as the disease itself, new research shows.

    The typical diabetes treatment regimen involves daily pills to control blood sugar, blood pressure, and cholesterol. And patients who require insulin may need multiple shots a day.

    Add to this the frequent finger pricks to monitor blood sugar, and strict instructions on diet and exercise, and many patients find the day-to-day burden of managing their disease to be too much, says Elbert Huang, MD, of the University of Chicago.

    “The idea that treatments are a burden to patients has largely been dismissed, yet we know that a large number of patients are not managing their disease as well as they could,” Huang tells WebMD. “In this study, we showed that for a minority of diabetes patients, comprehensive treatments negatively impact their quality of life in a significant way.

    Diabetes Treatment Burden

    Huang and colleagues conducted hour-long, in-person interviews with 701 adult patients with type 2 diabetes who were being treated at clinics in Chicago between May 2004 and May 2006.

    In an effort to better understand patient perceptions about the benefits and burdens of various treatments, the patients were asked to consider individual treatments and a spectrum of potential complications of poor diabetes management, ranging from angina and minor stroke to blindness, amputation, and kidney failure. Sixty-five percent of deaths in people with diabetes are due to heart disease and stroke.

    As expected, the patients were most concerned about end-stage complications of diabetes like kidney failure, major stroke, and blindness. They were somewhat less concerned about amputation and lesser vision damage.

    While the majority of patients indicated that life with treatment was not particularly burdensome, a surprising minority felt differently.

    Between 10% and 18% of patients reported that they would be willing to give up eight to 10 years of life in good health to avoid life with treatments.

    On average, the patients ranked the burden of comprehensive diabetes treatment and glucose control to be equal to the burden of angina, diabetic nerve damage, or kidney damage.

    The prospect of multiple daily insulin injections was more likely to be perceived as having a negative impact on quality of life than the prospect of taking many oral medications each day.

    The study appears in the October issue of the journal Diabetes Care.

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