부산대학교 도서관

Women with diabetes score lower on quality of life (QoL) measures than do women without diabetes or men with diabetes. Insulin therapy has also been associated with poorer QoL compared to treatment with diet or oral agents alone. We aimed to evaluate the effect of gender and diabetes therapy on QoL and to determine whether insulin therapy impacts QoL to a greater extent in women than men. The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) clinical trial enrolled patients with type 2 diabetes and coronary artery disease. A total of 2311 patients (681 female and 1630 male) had diabetes treatment information and QoL measures including Duke Activity Score Index (DASI), Energy/Fatigue, Health Distress and overall health rating at study entry. Diabetes treatment was classified as diet only, oral agents alone, or insulin. The effects of diabetes treatment, gender, and their interaction on QoL were assessed using multivariate linear regression. Significant differences in QoL measures were observed between genders and between diabetes treatment subgroups. Women had lower mean QoL scores than men, and insulin patients had lower mean QoL scores than those on oral agents or diet regardless of gender. Differences for DASI, Energy/Fatigue and Health Distress by gender and insulin use remained significant after adjustment for age, duration of diabetes, symptomatic complications (neuropathy, retinopathy, amputation, angina, heart failure), and country. The effect of diabetes therapy did not depend on gender (no significant statistical interactions). The estimated adjusted mean QoL scores are provided below. Psychological and physical well being are important for successful diabetes management. This study indicates that female patients who receive insulin have the worst QoL scores independent of symptomatic complications. Targeted interventions for this subgroup are recommended. [ABSTRACT FROM AUTHOR]