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Diabetes treatment-related quality of life is associated with levels of self-care activities in insulin injection among Japanese patients with type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 8)

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Abstract

Aims

We investigated the association between diabetes treatment-related quality of life (QOL) and levels of self-care activities in insulin injection among Japanese patients with type 2 diabetes.

Methods

Data from 1394 patients with type 2 diabetes on insulin therapy were obtained from a diabetes registry in Japan. We used the Diabetes Therapy-Related QOL (DTR-QOL) questionnaire and relative risk regression analysis to assess the independent association of high levels of self-care activities in insulin injection and DTR-QOL scores while adjusting for possible confounders.

Results

The mean age, BMI and HbA1c level were 65.8 years, 24.8 kg/m2 and 62 mmol/mol (7.8 %), respectively. The frequency of insulin injection omission was associated with DTR-QOL scores. In the multivariable-adjusted model, the relative risks for high levels of self-care activities in insulin injection was 1.15 (95 % confidence interval, 1.05–1.26) in the highest quintile compared with those in the lowest quintile of DTR-QOL scores. Subgroup analysis confirmed this association in patients <65 years.

Conclusions

DTR-QOL was associated with self-reported levels of self-care activities in insulin injection, particularly among Japanese patients <65 years with type 2 diabetes. DTR-QOL might be a useful tool to identify patients who consequently omit insulin. For patients with low DTR-QOL score, healthcare providers should discuss their treatment-related problems to prevent insulin injection omission.

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Acknowledgments

This study was partially supported by the Manpei Suzuki Diabetes Foundation and JSPS KAKENHI (Grant Number 25460641); however, they played no role in the study design or conduct, data collection, analysis or interpretation, and the preparation, review or approval of the manuscript. We would like to especially thank Yukari Moritsuji, Yuki Fujita, Noriko Nakamura and Yoko Sakamoto (Department of Endocrinology, Tenri Hospital) for their clerical support. The authors would like to thank Enago (www.enago.jp) for the English language review.

Conflict of interest

None declared for all authors.

Ethical standard

This study was approved by the Institutional Ethics Committee of Tenri Hospital.

Human and Animal Rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent disclosure

Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Department of Diabetology, Nara Medical University, 840 Shijo-cho, Kashihara City, Nara, 634-8552, Japan

    Tsuyoshi Mashitani & Hitoshi Ishii

  2. Department of Endocrinology, Tenri Hospital, Tenri, Nara, 632-8552, Japan

    Yasuaki Hayashino, Shintaro Okamura, Masako Kitatani, Miyuki Furuya, Tadao Iburi, Hirohito Kuwata & Satoru Tsujii

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  1. Tsuyoshi Mashitani
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Corresponding author

Correspondence to Tsuyoshi Mashitani.

Additional information

Managed by Antonio Secchi.

For the Diabetes Distress and Care Registry at Tenri Study Group.

Diabetes Distress and Care Registry at Tenri Study Group are listed in the Appendix.

Appendix

Appendix

Members of the Diabetes Distress and Care Registry at Tenri Study Group:

Shintaro Okamura, Miyuki Furuya, Masako Kitatani, Hirohito Kuwata, Satoru Tsujii (Department of Endocrinology, Tenri Hospital); Yasuaki Hayashino (Department of Endocrinology, Tenri Hospital, Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine); Hitoshi Ishii, Tsuyoshi Mashitani (Department of Diabetology, Nara Medical University); Satoshi Matsunaga (Department of Hematology, Endocrinology and Metabolism, Niigata University); Yaeko Kondo, Naotaka Fujita (Department of Diabetes and Clinical Nutrition, Kyoto University); Rei Ueda (Second Department of Internal Medicine, Faculty of Medicine, University of the Ryukyus), Rie Kawata (Sumire Hospital, Osaka), Masami Tanaka (Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University).

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Mashitani, T., Hayashino, Y., Okamura, S. et al. Diabetes treatment-related quality of life is associated with levels of self-care activities in insulin injection among Japanese patients with type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 8). Acta Diabetol 52, 639–647 (2015). https://doi.org/10.1007/s00592-015-0725-0

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