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The complex interplay between clinical and person-centered diabetes outcomes in the two genders
BACKGROUND: New approaches to cope with clinical and psychosocial aspects of type 2 diabetes (T2DM) are needed; gender influences the complex interplay between clinical and non-clinical factors. We used data from the BENCH-D study to assess gender-differences in terms of clinical and person-centered...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320673/ https://www.ncbi.nlm.nih.gov/pubmed/28222781 http://dx.doi.org/10.1186/s12955-017-0613-0 |
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author | Rossi, Maria Chiara Lucisano, Giuseppe Pintaudi, Basilio Bulotta, Angela Gentile, Sandro Scardapane, Marco Skovlund, Soren Eik Vespasiani, Giacomo Nicolucci, Antonio |
author_facet | Rossi, Maria Chiara Lucisano, Giuseppe Pintaudi, Basilio Bulotta, Angela Gentile, Sandro Scardapane, Marco Skovlund, Soren Eik Vespasiani, Giacomo Nicolucci, Antonio |
author_sort | Rossi, Maria Chiara |
collection | PubMed |
description | BACKGROUND: New approaches to cope with clinical and psychosocial aspects of type 2 diabetes (T2DM) are needed; gender influences the complex interplay between clinical and non-clinical factors. We used data from the BENCH-D study to assess gender-differences in terms of clinical and person-centered measures in T2DM. METHODS: Clinical quality of care indicators relative to control of HbA1c, lipid profile, blood pressure, and BMI were derived from electronic medical records. Ten self-administered validated questionnaires (SF-12 Health Survey; WHO-5 well-being index; Problem Areas in Diabetes (PAID) 5, Health Care Climate Questionnaire, Patients Assessment of Chronic Illness Care, Diabetes Empowerment Scale, Diabetes Self-care Activities, Global Satisfaction for Diabetes Treatment, Barriers to Taking Medications, Perceived Social Support) were adopted as person-centered outcomes indicators. RESULTS: Overall, 26 diabetes clinics enrolled 2,335 people (men: 59.7%; women: 40.3%). Lower percentages of women reached HbA1c levels < =7.0% (23.2% vs. 27.8%; p = 0.03), LDL-cholesterol < 100 mg/dl (48.3 vs. 57.8%; p = 0.0005), and BMI <27 Kg/m2 (27.2 vs. 31.6%; p = 0.04) than men. Women had statistically significant poorer scores for physical functioning, psychological well-being, self-care activities dedicated to physical activities, empowerment, diabetes-related distress, satisfaction with treatment, barriers to medication taking, satisfaction with access to chronic care and healthcare communication, and perceived social support than men; 24.8% of women and 8.8% of men had WHO-5 < =28 (likely depression) (p < 0.0001); 67.7% of women and 55.1% of men had PAID-5 > 40 (high levels of diabetes-related distress) (p < 0.0001). At multivariate analysis, factors associated with an increased likelihood of having elevated HbA1c levels (≥8.0%) were different in men and women, e.g. having PAID-5 levels >40 was associated with a higher likelihood of HbA1c ≥8.0% in women (OR = 1.15; 95%CI 1.05–1.25) but not in men (OR = 1.00; 95%CI 0.93–1.08). CONCLUSIONS: In T2DM, women show poorer clinical and person-centered outcomes indicators than men. Diabetes-related distress plays a role as a correlate of metabolic control in women but not in men. The study provides new information about the interplay between clinical and person-centered indicators in men and women which may guide further improvements in diabetes education and support programs. |
format | Online Article Text |
id | pubmed-5320673 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53206732017-02-24 The complex interplay between clinical and person-centered diabetes outcomes in the two genders Rossi, Maria Chiara Lucisano, Giuseppe Pintaudi, Basilio Bulotta, Angela Gentile, Sandro Scardapane, Marco Skovlund, Soren Eik Vespasiani, Giacomo Nicolucci, Antonio Health Qual Life Outcomes Research BACKGROUND: New approaches to cope with clinical and psychosocial aspects of type 2 diabetes (T2DM) are needed; gender influences the complex interplay between clinical and non-clinical factors. We used data from the BENCH-D study to assess gender-differences in terms of clinical and person-centered measures in T2DM. METHODS: Clinical quality of care indicators relative to control of HbA1c, lipid profile, blood pressure, and BMI were derived from electronic medical records. Ten self-administered validated questionnaires (SF-12 Health Survey; WHO-5 well-being index; Problem Areas in Diabetes (PAID) 5, Health Care Climate Questionnaire, Patients Assessment of Chronic Illness Care, Diabetes Empowerment Scale, Diabetes Self-care Activities, Global Satisfaction for Diabetes Treatment, Barriers to Taking Medications, Perceived Social Support) were adopted as person-centered outcomes indicators. RESULTS: Overall, 26 diabetes clinics enrolled 2,335 people (men: 59.7%; women: 40.3%). Lower percentages of women reached HbA1c levels < =7.0% (23.2% vs. 27.8%; p = 0.03), LDL-cholesterol < 100 mg/dl (48.3 vs. 57.8%; p = 0.0005), and BMI <27 Kg/m2 (27.2 vs. 31.6%; p = 0.04) than men. Women had statistically significant poorer scores for physical functioning, psychological well-being, self-care activities dedicated to physical activities, empowerment, diabetes-related distress, satisfaction with treatment, barriers to medication taking, satisfaction with access to chronic care and healthcare communication, and perceived social support than men; 24.8% of women and 8.8% of men had WHO-5 < =28 (likely depression) (p < 0.0001); 67.7% of women and 55.1% of men had PAID-5 > 40 (high levels of diabetes-related distress) (p < 0.0001). At multivariate analysis, factors associated with an increased likelihood of having elevated HbA1c levels (≥8.0%) were different in men and women, e.g. having PAID-5 levels >40 was associated with a higher likelihood of HbA1c ≥8.0% in women (OR = 1.15; 95%CI 1.05–1.25) but not in men (OR = 1.00; 95%CI 0.93–1.08). CONCLUSIONS: In T2DM, women show poorer clinical and person-centered outcomes indicators than men. Diabetes-related distress plays a role as a correlate of metabolic control in women but not in men. The study provides new information about the interplay between clinical and person-centered indicators in men and women which may guide further improvements in diabetes education and support programs. BioMed Central 2017-02-21 /pmc/articles/PMC5320673/ /pubmed/28222781 http://dx.doi.org/10.1186/s12955-017-0613-0 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Rossi, Maria Chiara Lucisano, Giuseppe Pintaudi, Basilio Bulotta, Angela Gentile, Sandro Scardapane, Marco Skovlund, Soren Eik Vespasiani, Giacomo Nicolucci, Antonio The complex interplay between clinical and person-centered diabetes outcomes in the two genders |
title | The complex interplay between clinical and person-centered diabetes outcomes in the two genders |
title_full | The complex interplay between clinical and person-centered diabetes outcomes in the two genders |
title_fullStr | The complex interplay between clinical and person-centered diabetes outcomes in the two genders |
title_full_unstemmed | The complex interplay between clinical and person-centered diabetes outcomes in the two genders |
title_short | The complex interplay between clinical and person-centered diabetes outcomes in the two genders |
title_sort | complex interplay between clinical and person-centered diabetes outcomes in the two genders |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320673/ https://www.ncbi.nlm.nih.gov/pubmed/28222781 http://dx.doi.org/10.1186/s12955-017-0613-0 |
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