title: The patient-doctor relationship and metabolic control in patients with type 1 (insulin-dependent) diabetes mellitus.
abstract: OBJECTIVE
  Our hypothesis was that patient-doctor relationship experienced positively by the patient is associated with adequate compliance behavior and thus to the long-term metabolic control of diabetes.
  
  
  METHODS
  Cross-sectional study of 100 consecutive adult patients with Type 1 diabetes treated in a diabetes out-patient department. From a questionnaire, four scores (direct estimate of physician, satisfaction with the place of treatment, self-esteem score, security with the patient-doctor relationship) determining the patient-doctor relationship were formed. In score 3 (self-esteem score) the impact of the patient-doctor relationship to the patients' self-esteem was indirectly estimated. The anonymous data taken from diabetes register including information about treatment of diabetes, metabolic control and end-organ complications were returned together with the questionnaire. On the basis of GHbA1c diabetic patients were divided into two groups: with adequate metabolic control (GHbA1c < or = 8.0%) or with poor/moderate control (GHbA1c > 8.0%).
  
  
  RESULTS
  In univariate analyses the score 3 associated with metabolic control (p < 0.001). In logistic regression analyses the nephropathy (t = 2.80, p < 0.05) and score 3 (t = 3.98, p < 0.001) were associated with metabolic control.
  
  
  CONCLUSIONS
  Patient's positively-experienced patient-doctor relationship was associated with good metabolic control of diabetes.
authors.affiliation: Department of Psychiatry, University of Kuopio, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Viinamäki
authors.forename: L
authors.initials: L
authors.lastname: Niskanen
authors.forename: T
authors.initials: T
authors.lastname: Korhonen
authors.forename: V
authors.initials: V
authors.lastname: Tähkä
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000378:metabolism / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000523:psychology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000378:metabolism / Q000523:psychology; D008297:Male; D010349:Patient Compliance; D010817:Physician-Patient Relations; D012649:Self Concept; D011795:Surveys and Questionnaires; D014167:Transference, Psychology