An assessment of diabetes-dependent quality of life (ADDQoL) in women and men in Poland with type 1 and type 2 diabetes.

INTRODUCTION: Quality of Life (QoL) of Polish women and men with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) was analyzed, taking into consideration acceptance of the illness, the occurrence of depression, complications of diabetes, concentration of glycated haemoglobin, and demographic factors. MATERIAL AND METHODS: The study was conducted among 115 patients with T1DM and 215 patients with T2DM aged 18-60. The patients were divided into women and men. The tool applied for studying QoL was the Polish language version of the Audit of diabetes-dependent QoL questionnaire(ADDQoL) comprising 2 questions related to the general QoL and 19 domains related to aspects of life. Each domain included 2 components: Impact and Importance, and their product determined the value of the weighted impact score. The Acceptance of Illness Scale, Beck Depression Inventory and studied demographic and clinical parameters were also applied. RESULTS: Patients with both types of diabetes demonstrated a negative influence of the disease in all domains of ADDQoL. Values of the average weighted impact of ADDQoL showed significant associations with diabetic complications in T1DM and gender and depressive symptoms in T2DM. Diabetes negatively affects the QoL of diabetic patients in Poland, especially regarding freedom to eat and to drink and sex life in both genders in T1DM, and freedom to eat and drink, and feelings about the future in both genders, and working life and sex life in T2DM men. CONCLUSIONS: Risk factors for worse QoL are: the occurrence of diabetes complications in T1DM patients and male gender and depression in T2DM patients.

Perception vs pain and beliefs about pain control and Type A behavior pattern in patients with chronic ischemia of lower extremities or with rheumatoid arthritis.

OBJECTIVE: The study aimed at determining the experience of pain taking into consideration beliefs about pain control, Type A behavior pattern and sociodemographic factors in patients with chronic ischemia of the lower extremities or with rheumatoid arthritis (RA). METHODS: The study enrolled 100 patients with peripheral arterial disease (PAD) and 100 patients with RA. The subjective sensation of pain was assessed using the Visual Analog Scale (VAS); beliefs about pain control were analyzed using the Beliefs about Pain Control Questionnaire (BPCQ), taking into consideration internal factors, the influence of physicians and accidental events (chance); and Type A behavior features (haste and competition) were analyzed using the Framingham Type A Scale. The multiple regression model was used to assess associations between the experienced pain and the BPCQ value, the Framingham Type A Scale and sociodemographic factors. RESULTS: The pain intensity degree was found to be comparable in patients with PAD and with RA. The median determined using the VAS was 5.75 in both of the studied groups. In patients with PAD, lower VAS values were associated with the BPCQ - internal factors (P<0.05) whereas a higher VAS value was related to the BPCQ - physicians' influence (P<0.001). In patients with RA, a higher VAS value was associated with BPCQ - physicians' influence (P<0.05), disease duration (P<0.05) and smoking cigarettes (P<0.05). CONCLUSION: Experiencing pain by patients with chronic ischemia of the lower extremities occurs at a moderate level and is beneficially connected with the internal factors and adversely connected with the external factors of beliefs about pain control. Patients with RA reported pain ailments of a moderate level in connection with the adverse influence of the external factors of beliefs about pain control, the duration of the disease and smoking cigarettes. Experiencing pain by patients with chronic ischemia of the lower extremities and RA does not seem to be related to Type A behavior.

Does Type 1 Diabetes Modify Sexuality and Mood of Women and Men?

BACKGROUND: Sexual disorders occurring in women and men with type 1 diabetes have not been sufficiently investigated and described until now. This study attempts to evaluate sexuality in women and men. METHODS: Altogether, the study comprised 115 patients with type 1 diabetes and 105 healthy people constituting the control group. All the studied persons underwent survey studies determining sexuality using the Female Sexual Function Index (FSFI-19) in women and the International Index of Erectile Function (IIEF-15) in men, and the occurrence of depression using the Beck Depression Inventory. The acceptance of illness among patients with diabetes was examined using the Acceptance of Illness Scale questionnaire. RESULTS: In 35% of the examined women with diabetes, the study demonstrated sexual dysfunction as determined by total FSFI. The point values of all the investigated FSFI domains were significantly lower in women with diabetes than in healthy ones (p < 0.001). Erectile dysfunction occurred in 50% of the studied men with diabetes and in 23% of the control group of men (p = 0.0017). CONCLUSIONS: Type 1 diabetes leads to sexual disorders which occur in 1/3 of women and in 1/2 of men. Sexual disorders in patients with diabetes more frequently occur in men, persons with coexisting complications of diabetes, and in those with a concentration of glycated hemoglobin higher than 6.5%.

Psychometric properties of the Audit of Diabetes-Dependent Quality of Life (ADDQoL) in a population-based sample of Polish adults with type 1 and 2 diabetes.

BACKGROUND: The aim of the present paper was the assessment of the psychometric properties of the Polish language version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire applied in Poland among patients with type 1 (T1DM) or type 2 diabetes (T2DM). METHODS: The studies were carried out among 330 patients with diabetes including 115 with T1DM and 215 with T2DM. In all the patients the level of the quality of life was investigated using the Polish language version of the ADDQoL and the psychometric properties were determined taking into consideration internal consistency, the factor loading and intraclass correlations. RESULTS: It was demonstrated that the values of internal consistency determining the reliability of the Polish language version of the ADDQoL for the overall Cronbach's alfa coefficient were 0.92 in the studied patients with T1DM and 0.93 in the studied patients with T2DM and the values of the loading factor were respectively 0.39-0.79 and 0.35-0.81. In the study of the correlation between the components of the ADDQoL the correlation coefficients proved to be highly statistically significant: in patients with T1DM r = 0.46-0.74 and in patients with T2DM - r = 0.42-0.80. CONCLUSION: The Polish language version of the ADDQoL is a reliable tool useful for the assessment of the level of the quality of life of adult patients with T1DM or T2DM in Poland and is recommended to be used among Polish-speaking patients with diabetes.

Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus.

An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, the age, and the subjective acceptance of the illness on sexual disorders occurring in women and men with type 2 diabetes. The study enrolled 215 patients (114 women and 101 men) with type 2 diabetes and 183 controls. Sexuality was determined in all of the studied subjects using: the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. The occurrence of depression symptoms was determined using the Beck Depression Inventory (BDI), whereas the acceptance of the illness in diabetic patients using the Acceptance of Illness Scale (AIS). A sexual dysfunction was found in 68% of the studied diabetic women and 17% of controls. The point values of all the examined FSFI domains were significantly lower in women with diabetes than in controls (p < 0.001). Erectile disorders occurred in 82% of the studied men with diabetes and in 41% of the controls (p < 0.001). The point values of all the domains of FSFI and IIEF demonstrated a significantly negative correlation with the total BDI score, which was higher in patients with diabetes than in patients without diabetes, and a positive correlation with the total AIS score (p < 0.001). The occurrence of sexual dysfunction in patients with diabetes correlated with the age and the duration of diabetes. We conclude that sexual disorders in patients with type 2 diabetes demonstrate the correlation with the occurrence of depression and the acceptance of their illness. Sexual disorders in diabetic patients occur more frequently in older patients and in those with a longer duration of diabetes.

Independent Factors of Changes of Ankle-Brachial Index in Peripheral Arterial Occlusive Disease in Elderly Patients with or without Diabetes.

Peripheral arterial disease (PAD) belongs to the commonly-occurring pathologies associated with elderly age. A simple tool for defining the severity of PAD is the ankle-brachial index (ABI). The purpose of this research was to determine independent factors of changes of ABI in elderly patients with occlusive PAD disease (PAOD) with and without diabetes. The research was carried out on 49 elderly patients with PAOD, including 29 patients with type 2 diabetes, and 20 patients without diabetes. The concentration of interleukin-6 (IL-6), E-selectin, fibrinogen, and C-reactive protein (CRP) in the blood serum was marked. In all patients, the independent factors of changes of ABI were determined with the use of the multiple logistic regression analysis. Our results show that in the group of patients with PAOD suffering from diabetes, it was demonstrated that the ABI was related to age, the duration of the symptoms of PAD, body mass index (BMI), low-density lipoprotein cholesterol, fibrinogen, and sex (determination coefficient R² = 0.699). In patients with PAOD without diabetes, the ABI was related to age, the duration of the symptoms of PAD, the levels of CRP, E-selectin, high-density lipoprotein cholesterol, and the glomerular filtration rate(determination coefficient R² = 0.844). We conclude that in elderly patients with PAOD with and without diabetes, the participation of independent factors related to the ABI is diversified; in patients with diabetes, the concentration of IL-6 and fibrinogen is lower, and the concentration of E-selectin is higher than in patients without diabetes.

Physical and mental health aspects of elderly in social care in Poland.

BACKGROUND: The objective of the study was to evaluate health aspects in elderly individuals in social, institutional, and home care in Poland. METHODS: A total of 300 elderly individuals in care in Poland were included in the study. The subjects were divided into three groups: residents of long-term care institutions (group I), residents of adult day-care homes (group II), and community-dwelling subjects (group III). Each group consisted of 100 subjects. Questionnaires evaluating the following physical and mental dimensions of health were used: SF-36 Health Survey, basic activities of daily living, instrumental activities of daily living, Geriatric Depression Scale, and Mini-mental state examination. RESULTS: It was found that the health aspects of the elderly varied depending on whether care was provided in an institutionalized or a home environment, and the lowest health status was found in the elderly receiving in-home care. Furthermore, home-based elderly indicated significant limitations in performing basic activities of daily living and instrumental activities of daily living, as well as a higher prevalence of depression and cognitive impairment. CONCLUSION: The elderly in long-term institutionalized care, both in a residential home and adult day-care homes, were characterized by a better physical and mental health status than those receiving in-home care. It seemed that worse health status, including the more frequent depression occurrence and cognitive function disorders in the elderly using the nursing care at their homes, was related to their multimorbidity, loneliness, and too-short duration of the care during the day.