Factors associated with psychological and behavioral functioning in people with type 2 diabetes living in France
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RESEARCH
Open Access
Factors associated with psychological and behavioral functioning in people with type 2 diabetes living in France Stephanie Boini1,2*, Marie-Line Erpelding1, Anne Fagot-Campagna3, Mounir Mesbah4, Judith Chwalow5, Alfred Penfornis6,7, Vincent Coliche7, Etienne Mollet7, Keith Meadows8, Serge Briançon1,2
Abstract Background: To identify demographic and clinical factors associated with psychological and behavioral functioning (PBF) in people with type 2 diabetes living in France. Methods: In March 2002, approximately 10,000 adults, who had been reimbursed for at least one hypoglycemic treatment or insulin dose during the last quarter of 2001, received a questionnaire about their health status and PBF (3,646 responders). For this analysis, the 3,090 persons with type 2 diabetes, aged 18-85 years old were selected. PBF was measured with the adapted version of the Diabetes Health Profile for people with type 2 diabetes. This permitted the calculation of three functional scores - psychological distress (PD), barriers to activity (BA), and disinhibited eating (DE) - from 0 (worst) to 100 (best). Results: Major negative associations were observed with PBF for microvascular complications (a difference of 6.7 in the BA score between persons with and without microvascular complications) and severe hypoglycemia (difference of 7.9 in the BA score), insulin treatment (-8.5 & -9.5 in the PD & BA scores respectively, as compared to treatment with oral hypoglycemic agents), non-adherence to treatment (-12.3 in the DE score for persons forgetting their weekly treatment), increasing weight (-8.5 & -9.7 in the PD & DE scores respectively, as compared to stable weight), at least one psychiatrist visit in 2001 (-8.9 in the DE score), and universal medical insurance coverage (-7.9 in the PD score) (due to low income). Conclusion: Prevention and management of microvascular complications or adherence to treatment (modifiable factors) could be essential to preserving or improving PBF among people with type 2 diabetes. A specific approach to type 2 diabetes management may be required in groups with a low socioeconomic profile (particularly people with universal medical insurance coverage), or other non modifiable factors.
Background At least 33 million people in European countries had diabetes in 2000. This number will be multiplied by 1.5 and will reach 48 million by 2030. A similar trend is observed in France [1]. The prevalence of diabetes is estimated at 3.95% and the yearly increase of the prevalence is at 5.7%. Six percent of mortality is related to diabetes and 5% of the resources of the health care * Correspondence: [email protected] 1 Clinical Epidemiology and Evaluation, CIC-EC CIE6 Inserm, University hospital of Nancy, France Full list of author information is available at the end of the article
system are used by people with diabetes [2]. Diabetes is a “fraught with consequences” chronic disease due to its life-threatening complications and reduced life expectancy. It may develop from a non-symptomatic disease
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