RESEARCH PAPER
Type 2 diabetes mellitus in relation to place of residence: evaluation of selected aspects of socio-demographic status, course of diabetes and quality of life – a cross-sectional study
 
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1
Department of Endocrinology, Medical University, Lublin, Poland
 
2
Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University, Lublin, Poland
 
3
Department of Mathematics and Medical Biostatistics, Medical University, Lublin, Poland
 
 
Corresponding author
Marta Dudzińska   

Department of Endocrinology, Medical University, Lublin, Poland
 
 
Ann Agric Environ Med. 2013;20(4):869-874
 
KEYWORDS
ABSTRACT
Introduction and objective:
This study aims at answering what are the differences in socio-demographic status of patients with type 2 diabetes living in the city and the countryside and what is the impact of a place of residence on the level of metabolic control, the incidence of complications of diabetes and quality of life (QoL).

Material and Methods:
274 patients were divided into 2 groups: residents of rural areas-28.2% (n=77) and residents of urban areas-71.9% (n=197). Self-reported questionnaires was used: EQ-5D, DQL-BCI and DSC-R.

Results:
The group of residents of the countryside was characterized by a lower income and education level and a higher number of persons with disability pension. Patients living in the country had a higher body mass index in comparison to town inhabitants (32.6kg/m2 vs 30.9kg/m2, p=0.008) and shorter diabetes duration (8.4 versus 11.3 years, p=0.008). There were no differences between residents of the countryside and towns in terms of the method of treatment (oral antidiabetic drugs: 70.1% and 65.5%, p=0.3, Insulin: 29.9% and 36.5%, p=0.3, respectively), occurring chronic complications of diabetes (retinopathy: 14.3% and 14.2%, neuropathy: 6.5% and 7.6%, coronary heart disease: 44.45 and 37.1%, respectively) and the availability of diabetologists. Patients living in the countryside did not differ from town inhabitants in metabolic control and QoL assessment (EQ-5D index: 0.80 vs 0.79, p=0.9, EQ-VAS: 56.2 vs 54.3, p=0.2, DQL-BCI: 56.0 vs 53.9, p=0.1, DSC-R: 29.6 vs 29.4, p=0.7).

Conclusions:
The socio-demographic differences between groups dependent on the place of living did not exert a significant influence on the level of metabolic control of diabetes, the incidence of late complications or QoL assessment in the population studied.

REFERENCES (38)
1.
Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010; 87(1): 4–14.
 
2.
Czech A, Głowacka I. Potrzeby, metody i wyniki oceny jakości leczenia cukrzycy. Med Metabol. 2005; 9(3): 76–83.
 
3.
Shichiri M, Kishikawa H, Ohkubo Y, et al. Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients. Diabetes Care 2000; 23(Suppl 2): B21–29.
 
4.
Stratton IR, Adler AI, Neil HA, the UK Prospective Diabetes Study Group. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405–412.
 
5.
The Diabetes Control and Complications Trial Research Group: The effect of Intensive treatment of Diabetes on the Development and progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus. NEJM 1993; 329(14): 977–986.
 
6.
U.K. Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. UKPDS 33. Lancet 1998; 352(9131): 837–853.
 
7.
Szende A, Williams A. Measuring Self-Reported Population Health: An International Perspective based on EQ-5D. EuroQol Group. SpringMEDPublishing. 2004. http://www.euroqol.org.
 
8.
Golicki D, Jakubczyk M, Niewada M, et al. Valuation of EQ-5D Health States in Poland: First TTO-Based Social Value Set in Central and Eastern Europe. Value in Health 2010; 13(2): 289–297.
 
9.
Burroughs TE, Desikan R, Brian M, et al. Development and Validation of the Diabetes Quality of Life Brief Clinical Inventory. Diabetes Spectrum 2004; 17(1): 41–49.
 
10.
Jacobson AM, De Groot M, Samson JA. The evaluation of two measures of quality of life in patients with type I and II diabetes. Diabetes Care 1994; 17(4): 267–274.
 
11.
Burroughs TE. Development and Validation of Diabetes Quality of Life- Brief Clinical Inventory. Administrator’s Manual, v3.2. Saint Louis: Saint Louis University Center for Outcomes Research, 2006.
 
12.
Dudzińska M, Tarach JS, Burroughs TE, Zwolak A, Matuszek B, Smoleń A, Nowakowski A. Validation of the Polish version of Diabetes Quality of Life – Brief Clinical Inventory (DQL-BCI). Arch Med Sci. 2013, in press.
 
13.
Grootenhuis PA, Snoek FJ, Heine RJ, et al. Development of type 2 Diabetes Symptom Checklist: a Measure of Symptom Severity. Diabetic Med. 1994; 11(3): 253–261.
 
14.
Arbuckle RA, Humphrey L, Vardeva K, et al. Psychometric Evaluation of the Diabetes Symptom Checklist-Revised (DSC-R)—A Measure of Symptom Distress. Value in Health 2009; 12(8): 1168–1175.
 
15.
http://www.mapi-trust.org (access: 12.03.2012).
 
16.
Jaworska J. Ocena warunków medyczno-społecznych chorych na cukrzycę. Praca Doktorska. Akademia Medyczna w Lublinie, Międzywydziałowa Katedra i Zakład Zdrowia Publicznego, Lublin 2005.
 
17.
Herbut D. Subiektywna ocena stanu zdrowia i jakości życia pacjentów z cukrzyca typu 1. Praca doktorska. Uniwersytet Medyczny w Lublinie, Katedra i Klinika Endokrynologii. Lublin 2008.
 
18.
Żmurowska B. Porównanie samooceny stanu zdrowia pacjentów z cukrzycą typu 2 leczonych w poradni specjalistycznej i poradni lekarza rodzinnego. Med Metab. 2005; 9(4): 56–67.
 
19.
Łopatyński J, Mardarowicz G, Nicer T, et al. Badania nad występowaniem cukrzycy typu 2 w populacji powyżej 35 roku życia na wsi i w mieście w regionie lubelskim. Pol Arch Med Wewn. 2001; 106: 781–786.
 
20.
Łopatyński J. Zespół metaboliczny na Lubelszczyźnie- występowanie. Diabetol Prakt. 2002; 3(supl B): B15.
 
21.
Sieradzki J, Grzeszczak W, Karnafel W, et al. Badanie PolDiab. Część I. Analiza leczenia cukrzycy w Polsce. Diabetol Prakt. 2006; 7(1): 8–15.
 
22.
Szcześniak G. Ocena jakości opieki ambulatoryjnej nad pacjentami z cukrzycą typu 2 i jej wpływu na ich jakość życia. Praca Doktorska. Akademia Medyczna w Lublinie, Katedra i Zakład Medycyny Rodzinnej. Lublin 2007.
 
23.
Malec K, Molenda P, Homa K, et al. Opieka diabetologiczna i samokontrola u chorych na cukrzycę typu 2 zamieszkujących gminę rolniczą w województwie zachodniopomorskim. Pol Arch Med Wewn. 2008; 118(1–2): 29–34.
 
24.
Szurkowska M, Pyrzyk B, Nazim A, et al. Ocena jakości leczenia chorych na cukrzycę typu 2 w populacji wielkomiejskiej i populacji wiejskiej. Diabetol Pol. 2002; 9(3): 103–109.
 
25.
Malec K, Molenda P, Homa K, et al. Wyrównanie cukrzycy typu 2 zamieszkujących gminę rolniczą w województwie zachodniopomorskim. Diabetol Prakt. 2007; 8(8–9): 295–300.
 
26.
Sieradzki J, Kasperska-Czyżyk T, Grzeszczak W, et al. Wyniki ogólnopolskiego badania DYNAMIC 2 (II). Diabetol Prakt. 2003; 4(2): 103–111.
 
27.
Łagowska-Batyra A, Matuszek B, Lenart-Lipińska M, Strawa-Zakościelna K, Nowakowski A. Comparison of course of type 2 diabetes in village and town inhabitants in the Lublin region. Annales UMCS, Sectio DDD. 2010; 23(3): 69–77.
 
28.
Schiel R, Hoffmann A, Müller UA. Quality of care of patients with diabetes mellitus living in a rural area of Germany. Med Klin. 1999; 94(3): 127–132.
 
29.
Befort CA, Nazir N, Perri MG. Prevalence of obesity among adults from rural and urban areas of the United States: findings from NHANES (2005–2008). J Rural Health 2012; 28(4): 392–397.
 
30.
Babicz-Zielińska E, Szczepańska W, Śleszyńska E. The problem of overweight and obesity in general practice. Fam Med Prim Care Rev. 2010; 12(3): 577–580.
 
31.
Thommasen HV, Berkowitz J, Thommasen AT, Michalos AC. Understanding relationships between diabetes mellitus and health-related quality of life in a rural community. Rural Remote Health 2005; 5: 441.
 
32.
Quandt SA, Graham CN, Bell RA, Snively BM, Golden SL, Stafford JM. Ethnic disparities in health-related quality of life among older rural adults with diabetes. Arcury TA Ethn Dis. 2007; 17(3): 471–476.
 
33.
Davis TM, Clifford RM, Davis WA. Effect of insulin therapy on quality of life in type 2 diabetes mellitus: The Fremantle Diabetes Study. Diabetes Res Clin Pract. 2001; 52: 63–71.
 
34.
Pufal J, Gierach M, Pufal M, et al. Wpływ czynników społeczno-demograficznych i klinicznych na jakość życia chorych na cukrzycę typu 2. Diabetol Dośw Klin. 2004; 4(2): 137–143.
 
35.
Wee HL, Tan CE, Goh SY, et al. Usefulness of the Audit of Diabetes-Dependent Quality-of-Life (ADDQoL) questionnaire in patients with diabetes in a multi-ethnic Asian country. Pharmacoeconomics 2006; 24(7): 673–682.
 
36.
Lloyd A, Saweyr W, Hopkinson P. Impact of Long-Term Complications on Quality of Life in Patients with Type 2 Diabetes not Using Insulin. Value In Health 2001; 4(5): 392–400.
 
37.
Bursröm K, Johannesson M, Diderichsen F. Health-related quality of life by disease and socio-economic group in the general population in Sweden. Health Policy 2001; 55: 51–69.
 
38.
Papadopoulos AA, Kontodimopoulos N, Frydas A, Ikonomakis E, Niakas D. Predictors of health-related quality of life in type II diabetic patients in Greece. BMC Public Health 2007; 30(7): 186.
 
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