The Burden of Self-Care is a Heavy Burden Indeed

Recently, researchers from the University of Chicago interviewed 701 adults with diabetes in order to quantify and rank their feelings about diabetes-related complications and about the self-care necessary to avoid those complications.

They wanted, for example, to find out which is worse: having to manage years of intensive treatment, or ending up living a few years less.

When it came to the burden of diabetes control, people rated intensive glucose control as worse than conventional glucose control. Worst of all was intensive control with multiple therapies, such as medications and insulin. In fact, intensive comprehensive control was rated as just as destructive to quality of life as intermediate complications.

Not surprisingly, people rated end-stage complications like blindness and kidney failure as the very worst. But short of those drastic outcomes, they were willing to make some major trade-offs to avoid the exhausting routine of taking care of themselves in the here and now. In fact, they ranked the burden of comprehensive diabetes care as just as bad as developing angina, diabetic nerve damage, and moderate kidney damage.

It’s not surprising that while caregivers are focused solely on preventing long-term complications, patients are preoccupied with the daily pain in the neck, right here and now, that it takes to prevent those far-off outcomes.

Between ten and eighteen percent of patients were willing to give up eight to ten years of future healthy life in order to avoid managing their diabetes intensively right now. It’s a telling testimonial to exactly how debilitating diabetes self-care can be.

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Sources: EurekAlert; Diabetes Care, October 2007

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