Diabetes Treatment a Burden to Many
Insulin Injections Cause Most Distress
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
Simpler Diabetes Treatments Needed
As many as 20.8 million adults and children have diabetes, according to the
Studies suggest that a large percentage of patients with diabetes have
poorly controlled blood sugar, blood pressure, and cholesterol because they are
not being optimally treated.
Huang says the problem may only get worse as the definition of optimal
treatment evolves to include even more drugs and more complicated therapeutic