Frequency and perceived burden of diabetes self-management activities in employees with insulin-treated diabetes: relationships with health outcomes

Abstract

We explored the relationship between frequency and perceived burden of different self-management activities and HbA 1c %, symptoms of diabetes, fatigue, depression, and quality of life in 292 employees between 30 and 60 years of age with insulin-treated diabetes. Participants completed questionnaires that assess self-management and health-related variables. t-Tests were performed for type 1 (DM1) and type 2 diabetes (DM2) separately to compare the mean health scores of individuals who frequently or infrequently perform self-management activities and who do or do not perceive this as a burden. Participants frequently perform their self-management activities, particularly injection of insulin (96.1%), following dietary guidelines (70.8%) and eating regularly (65.6%). Dietary self-management is most often seen as a burden (70.4%), while injecting insulin is seen as least burdensome (12.8%). The perceived burden of self-management is more strongly related to health than the frequency of self-management. Frequency of self-management especially relates to HbA 1c % in DM1. People with DM2 who frequently follow the dietary guidelines have more positive health outcomes. Participants who perceive dietary self-management and injecting insulin as a burden have more negative health outcomes. Because different relationships were found between frequency and perceived burden of self-management and health

Chronic Fatigue in Type 1 Diabetes: Highly Prevalent but Not Explained by Hyperglycemia or Glucose Variability

“…Literature provides limited evidence for higher levels of fatigue in diabetic patients (6,7), but its chronicity, impact, and determinants are unknown. In various chronic diseases, it has been proven useful to distinguish between precipitating and perpetuating factors of chronic fatigue (3,8).…”

“…This model encompasses not only physiological factors, such as hyperglycemia, hypoglycemia, and glucose variability (11,12,14), but also psychological factors, such as diabetes-related emotional distress. In addition to the aforementioned variables, demographic variables, specific fatigue-related factors, and current health status, including depressive mood, pain (6), and the presence of comorbidities, (15) may also determine chronic fatigue. We established the relationship between these factors and chronic fatigue in T1DM.…”

Diabetes Intrusiveness and Wellness Among Elders: A Test of the Illness Intrusiveness Model

“…Health and disease-related factors like advancing age (Carroll, Ackermann, Brizendine, Shen, & Marrero, 2007;El-Kebbi et al, 2003;Wagner, Müller-Godeffroy, von Sengbusch, Häger, & Thyen, 2005); diabetes type (Likitmaskul et al, 2006;Stettler et al, 2006); years with a diabetes diagnosis (de Pablos-Velasco, Ricart, Monereo, Moreno, & Marrugat, 2003); symptoms and disease severity (Cerveny, Leder, & Weart, 1998;Hörnquist, Wikby, Stenstrohm, Andersson, & Akerland, 1995); comorbid conditions like heart disease, hypertension, or obesity (Daviglus et al, 2003;Nguyen et al, 2011) all influence biopsychosocial adjustment to diabetes. Treatment factors found to influence disease intrusiveness and adjustment include receiving diabetes education (Petrak et al, 2005), prescribed insulin injections, restrictive diets, or exercise plans as well as the degree of adherence to these medical orders (Weijman et al, 2005). Frequency of physician-primary care visits or number of hospital stays (O'Connor et al, 1998) also influence the intrusiveness of diabetes, detracting time spent on other life roles and events.…”

Management of Diabetes Mellitus with Insulin Lispro

“…4 There is no doubt that insulin is the most effective hypoglycemic agent, but insulin therapy often raises problems in the social activities, physical function and emotional status of patients. [5][6][7] With intensive treatment, multiple injections or severe hypoglycemia may worsen the patient's quality of life (QOL) and may induce compliance problems with insulin therapy. 8 Regular human insulin (RHI) has several limitations in terms of blood glucose control and patients' QOL.…”