Socio-economic characteristics and quality of life in diabetes mellitus-relation to metabolic control

Diabetes mellitus is a chronic metabolic disease with wide implications for well-being and social life. The aim of this cross-sectional, observational study was to describe possible differences in clinical characteristics, socio-economic factors and quality of life between diabetes patients in poor and good/acceptable metabolic control, as defined by levels of glycated haemoglobin A1c. From a population-based register of diabetes patients at a clinical chemistry department, we selected 96 subjects in poor metabolic control (HbA1c > 10%), and 96 subjects in good/acceptable (HbA1c 6.5-7.5%) metabolic control, matched for sex, age and duration of diabetes. Each participant was sent a self-administered questionnaire regarding medical history, family situation and socio-economic background, as well as self-rated health based on a validated instrument (SF-36). The diabetes patients in poor metabolic control reported more retinopathy, vascular complications and nervous problems than did the patients in acceptable metabolic control. Furthermore, the group in poor metabolic control was also characterized by a lower educational level, a higher number of sick leave days or disability pension and a lower degree of physical activity. Both of the diabetic groups reported lower scorings for physical functioning, general health, vitality and mental health, than did a comparable non-diabetic group from another study. In summary, diabetic patients in poor metabolic control have a lower educational level and report more complications, nervous problems, sick leave days and disability pensions than patients in good/acceptable metabolic control. The lower degree of physical activity adds to the problems of the first group and should be the target for intervention to achieve better metabolic control.