Health status and quality of life deteriorated in diabetic

The study ENTRED ( witness representative national sample of people with diabetes ), the results were presented to the Ministry of Health draws the profile of diabetic patients in France: patients whose state of health and quality of life are quite degraded
Diabetes in France : epidemiological situation
This study is based on analysis of repayments care insurance diabetes and 10,000 questionnaires sent to 4,400 patients and 2,200 physicians disease.

10,000 patients were randomly selected from a population of insured benefiting from reimbursement of oral antidiabetic agents or insulin , and thus considered to be diabetic . Patients treated with diet alone are not represented in this study.

In this sample , 52 % of patients 65 years or older and 18% were 75 years and older. " More than half of people with diabetes living in France under the category ' Diabetes in the elderly " , the investigators note .

A second person has a family history of diabetes. Diabetes diagnosis was made an average of 52 years. Patients know that they were suffering from diabetes for an average of a dozen years .

If these patients are treated with oral antidiabetic agents or insulin , they admit little respect the lifestyle advice . Half believe follow the diet difficult and only 10% of those aged under 65 have moderate to vigorous sporting activity at least 2 hours per week .

The quality of glycemic control is not known, but 12% have lived show at least one episode of severe hypoglycemia , that is to say, requiring the assistance of another person. This proportion is higher (29% ) in patients treated with insulin .

Patients often suffer from other diseases in addition to diabetes.

A high vascular risk
Almost all ( 93%) had at least one vascular risk factor in addition to diabetes : 51 % have high cholesterol , 54% hypertension , 41% are overweight ( body mass index greater than or equal to 25 kg / m2) and 34 % are obese (greater than or equal to 30 BMI) , 50% have smoked in their lives and 16% still smoke .

As for complications , at least 39% of patients reported having developed a complication : 17% were treated for retinopathy , 4 % lost the sight in one eye , 7 % suffered from foot ulceration .

For cardiovascular complications , 17% of patients reported a history of myocardial infarction or angina, 10 % underwent coronary intervention (bypass or angioplasty) as preventive or curative treatment of myocardial infarction.

Faced with the risk of angina or heart attack patients do not seem equal: men, elderly, less mobile or obese patients treated with insulin or with a long-standing diabetes or people living alone more represented.

An impaired quality of life
These complications significantly affect the quality of life of patients . Some (infarction, risk of hypoglycaemia) are perceived as obstacles to the activities of daily life and emphasize the psychological distress.

Thus , 7 % say they are limited in their daily activities due to diabetes , 14% are limited in their activities because of another problem , which highlights the impact of polymorbidity diabetic patients about their quality of life.

The insulin treatment is also associated with poorer quality of life , probably because it reflects the severity of the disease . The scores are also better when the injections are made by the patient himself and not by a nurse, which underlines the importance of autonomy for patients.

Professional impact of diabetes is also important : 11% said they had changed their occupation because of their diabetes. The transition to a part-time city in 12 % of cases, the shift in 13 % of cases and setting long-term illness or disability in 49 % of cases.

All this comes in an often difficult socio -economic context. Over a quarter of patients live only effect , half a lower level of study or equal to the primary certificate .

About a third part of the socio- professional category of workers, a third of those employees or technicians ( technician, supervisor , nurse) and 15% are executives . Only one in five had an occupation at the time of the survey.

However, the cost of care as a barrier to care was highlighted in the study ENTRED in 18% of patients.