Burden of diabetes care rivals disease complications

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NEW YORK, Oct 3 (Reuters) Many diabetic patients say the inconvenience of staying on top of their disease and the discomfort of daily insulin injections harms their quality of life as much as diabetes-associated complications, new research suggests.

''An important minority of patients believe that comprehensive diabetes treatments have a significant negative impact on quality of life that is comparable to that of life with complications. We did not know that such a large proportion of patients would report this,'' lead author Dr Elbert S Huang, from The University of Chicago, told Reuters Health.

A typical diabetes patient takes several medications each day, including two or three different pills to control blood sugar levels, one or two to lower cholesterol, two or more to reduce blood pressure and a daily aspirin to prevent blood clots. They must also exercise and stick to a strict diet. As the disease progresses, the drugs increase, often including insulin shots.

To study the burden of diabetes care, Huang and colleagues interviewed 701 adult patients with diabetes who were seen at Chicago area clinics. The subjects were asked to rank treatment benefits as well as the impact that various complications had on quality of life.

As expected, patients were most distressed by end-stage complications, especially kidney failure, stroke, or blindness.

They were slightly less concerned about amputations or diabetic retina damage, and still less about angina (chest pain), diabetic nerve or kidney damage.

Patients also disliked intensive treatments, especially intensive blood sugar control, with multiple daily insulin injections, and what the authors called comprehensive diabetes care, which was intensive blood sugar control plus other medications.

Many patients found both complications and treatment onerous.

Between 12 and 50 per cent were willing to give up 8 of 10 years of life in perfect health to avoid life with complications, the authors found, while between 10 and 18 per cent of patients were willing to give up 8 of 10 years of healthy life to avoid life with treatments.

''This tells us that we need to find better, more convenient ways'' to treat diabetes and other chronic illnesses, Huang said in a university statement.

Reuters SG DB0931

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