Abstract:
Aim To investigate the change in personal impact of diabetes, in the same patients, over 5 years. Methods Subjects were 144 Europeans and 63 Polynesians. Personal impact was measured by closed questions asking if diabetes affected work, interests, home life, social life and home relationships. Results After 5 years participants had deteriorated metabolic measures and more frequent and severe complications. Nevertheless, the personal impact from having any problem caused by diabetes reduced by 60%. Knowledge of diabetes and self-blood glucose monitoring had improved. People were more likely to accept their diagnosis and were less concerned if others knew. They wanted to know more about diabetes, they felt more in control of the condition and found food restrictions less onerous, but were more worried by their diabetes. Conclusion Personal impact of diabetes decreased over 5 years. This and associated attitudinal changes, probably explained by ‘response shift’, produce both challenges and opportunities for clinicians seeking to educate and motivate patients. We need to ask patients directly rather than presume how diabetes is impacting on their life. Only then can we construct joint knowledge with our patients in ways that are personalized to their current attitudes and concerns.
