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Perception of diabetes may affect how patients manage disease, prognosis
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Patients’ perception of what causes diabetes and their personal level of risk for the disease may affect how they go on to manage the condition if diagnosed, according to research in The Diabetes Educator.
In a study of adults at risk for diabetes, most participants inappropriately identified diet and eating habits as causes of diabetes, suggesting a need for more outreach and education, according to researchers.
“A diet high in calories contributes to weight gain and potentially to being overweight, but such a diet is not, in and of itself, a cause of diabetes,” the researchers wrote. “To prevent or delay the onset of diabetes, education about diabetes and its causes is clearly needed by persons at risk.”
Shiela M. Strauss, PhD, associate professor of nursing and co-director of the statistics and data management core for New York University’s Colleges of Nursing and Dentistry, and colleagues analyzed data from 372 adults (57.8% women; 72.3% aged 45 years or older) at risk for diabetes who were involved in research on the potential to screen at-risk persons for diabetes during a dental visit. A total of 46% of participants had HbA1c values in the prediabetes or diabetes range, according to researchers, with an average HbA1c value of 5.6% (38 mmol/mol), just less than the elevated range of at least 5.7% (39 mmol/mol). The study took place between June 2013 and April 2014.
Shiela M. Strauss
Researchers asked participants to review 10 illness symptoms — only five related to diabetes — and note which ones they experienced in the past week. Diabetes symptoms included frequently feeling thirsty, blurred vision, frequent visits to the toilet, weight loss and a lack of energy. Researchers also asked participants to complete an assessment about the effect of diabetes on glucose, diabetes diet, types of diabetes, causes of the disease and high blood glucose levels. Researchers measured diabetes illness perceptions with a brief illness perception questionnaire (Brief IPQ), using a single-item scale from 0 to 10 for each of eight dimensions of diabetes illness perceptions.
Participants aged 18 to 44 years reported more symptoms that made them think they had diabetes and reported being more concerned that they had the disease vs. those aged 45 years or older (2.5 vs. 1.9, P = .019; 4.7 vs. 3.8, P = .03, respectively). Participants without a first-degree relative with diabetes were less concerned they may have the disease than those with a relative with diabetes (3.7 vs. 4.6, P = .017), had a poorer understanding of diabetes (4.9 vs. 5.6, P = .024) and were less emotionally affected by the possibility of having diabetes (4.9 vs. 5.9, P = .003).
In addition, more participants who were black, Native American, Asian and Pacific Islander — compared with those with lower risk for diabetes due to race — underestimated the likely duration of diabetes (6.3 vs. 7.2, P = .011), overestimated the amount of personal control one has over the disease (7.9 vs. 6.9, P < .001), believed that treatment would help the illness (8.9 vs. 8.3, P = .005) and professed a better understanding of the disease (5.7 vs. 4.9, P = .017).
The findings suggest that those at risk for diabetes may have different perceptions than those already diagnosed with the disease, and a more tailored approach to education is needed, according to researchers.
“Whenever possible, when educating an at-risk patient, it would be helpful to have the patient complete a brief, valid instrument, such as the Brief Illness Perception questionnaire, to understand the patient’s specific illness perceptions,” Strauss told Endocrine Today. “Education can then be targeted to address the patient’s specific perceptions and needs.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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