title: 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).
abstract: OBJECTIVE
  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/m(2) 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.
authors: Department of Diabetology, Nara Medical University, 840 Shijo-cho, Kashihara City, Nara, 634-8552, Japan, mashiyan@gmail.com.
authors: Tsuyoshi
authors: T
authors: Mashitani
authors: Yasuaki
authors: Y
authors: Hayashino
authors: Shintaro
authors: S
authors: Okamura
authors: Masako
authors: M
authors: Kitatani
authors: Miyuki
authors: M
authors: Furuya
authors: Tadao
authors: T
authors: Iburi
authors: Hirohito
authors: H
authors: Kuwata
authors: Satoru
authors: S
authors: Tsujii
authors: Hitoshi
authors: H
authors: Ishii
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012042:Registries; D012648:Self Care / Q000592:standards; D057566:Self Report; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires
chemical_list: D007328:Insulin