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- H Dorchy and S Olinger.
- Clinique de Diabétologie, Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgique.
- Presse Med. 1997 Oct 11; 26 (30): 142014241420-4.
ObjectiveThe principal aim of therapeutic management of the child, adolescent and adult with type I diabetes is to avoid severe hypoglycemia and long-term complications, by maintaining blood glucose concentrations and thus glycated hemoglobin levels (HbA1c)-dose to the normal range. However, the therapeutic constraints should not decrease the quality of life and well-being of patients. Therefore, the purpose of the present study was to evaluate by a questionnaire the well-being of our autonomous diabetic adolescents and young adults in relationship with their HbA1c levels and other characteristics.Patients And MethodsA total of 100 unselected subjects (73 men and 44 women), with a mean age of 21 years (14-38) and a mean diabetes duration of 12 years (0-26), were included in the study over a 3-month period. Mean age at onset of diabetes was 10 years. Twenty-five percent of the patients were of Moroccan origin. All the patients were autonomous for self-management and treatment. Their socioeconomic status was not different from that of the normal population. The mean annual HbA1c level in the 100 diabetic patients was 7.3 (4.7-11.7). Well-being was measured using a questionnaire developed by a working group of the World Health Organisation, International Diabetes Federation and St Vincent Declaration. The questionnaire included 4 subscales labelled depression, anxiety, energy and positive well-being. The measurement of all 4 subscales involved 22 items and allowed an estimation of general well-being.ResultsGeneral well-being in women was not as good as in men due to a greater tendency toward depression. Well being was better in patients with a professional activity than in the others. Patients age, duration of diabetes, number of insulin injections, frequency of home blood glucose monitoring, presence of 1 or 2 subclinical complications, had no effect on well-being. On the other hand, well-being was negatively correlated with the HbA1c levels: higher the HbA1c, higher the anxiety and the depression, and lower the energy and the positive well-being.ConclusionWell-being was mainly associated with HbA1c levels; it improved with better glucemic control.
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