Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes.
BACKGROUND
Because the projected increase in the number of diabetic patients is expected to strain the capabilities of health care providers worldwide, we are challenged to find ways of reducing the burden of diabetes. Maintaining and improving health-related quality of life (QoL) for diabetic patients may be viewed as public health goals.


OBJECTIVE
The aim of this cross-sectional study was to compare different aspects of health, QoL, and quality of care (QoC) between men and women with diabetes as a basis for planning and managing diabees care.


METHODS
All patients in 2 age groups (aged 20-30 years [younger age group] and aged 50-60 years [middle-aged group]) who were registered with the Department of Endocrinology, Metabolism, and Diabetes at Karolinska University Hospital, Stockholm, Sweden, in October 2004, were recruited for a survey. Questions were included about self-rated health (SRH), QoL, QoC, diabetes-related worries, occupational status, physical activity level, living arrangements, and educational background. Glycosylated hemoglobin (HbA1c) values were obtained from medical records.


RESULTS
Of the 223 eligible patients (109 men, 114 women) in the younger age group, 49 men and 74 women responded to the questionnaire; of the 300 eligible patients (170 men, 130 women) in the middle-aged group, 120 men and 93 women responded. Middle-aged women rated their mental well-being and QoL as worse compared with men (P < 0.001 and P < 0.05, respectively). In both age groups, women reported more diabetes-related worries and less ability to cope (P < 0.05 for the younger age group and P < 0.001 for the middle-aged group for both variables), thus the differences were more marked for middleaged women. Although there were no gender differences in metabolic control, middle-aged women reported less satisfaction with diabetes care (P < 0.001). Higher HbA1c was related to worse SRH in both men and women when analyzing the age groups together (P < 0.05). This association was most prominent in young women, in whom having more diabetes-related worries was also related to higher HbA1c (P < 0.01).


CONCLUSIONS
In this study, women with diabetes appeared to have worse QoL and mental well-being compared with men with diabetes. Therefore, identifying strategies to improve SRH and QoL among diabetic patients, especially among women, is of great importance.
Center for Family and Community Medicine, Stockholm, Sweden. anna-lena.unden@ki.se <anna-lena.unden@ki.se>
Anna-Lena
AL
Undén
Stig
S
Elofsson
Anna
A
Andréasson
Eva
E
Hillered
Ingeborg
I
Eriksson
Kerstin
K
Brismar
D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D015190:Blood Glucose Self-Monitoring; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D011788:Quality of Life; D012647:Self-Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden
D006442:Glycated Hemoglobin