Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Feb 21;15(1):41.
doi: 10.1186/s12955-017-0613-0.

The complex interplay between clinical and person-centered diabetes outcomes in the two genders

Maria Chiara Rossi  1 , Giuseppe Lucisano  2 , Basilio Pintaudi  3 , Angela Bulotta  4 , Sandro Gentile  5 , Marco Scardapane  2 , Soren Eik Skovlund  6 , Giacomo Vespasiani  7 , Antonio Nicolucci  2 ; BENCH-D Study Group
Collaborators, Affiliations
Comparative Study

The complex interplay between clinical and person-centered diabetes outcomes in the two genders

Maria Chiara Rossi et al. Health Qual Life Outcomes. .

Abstract

Background: New approaches to cope with clinical and psychosocial aspects of type 2 diabetes (T2DM) are needed; gender influences the complex interplay between clinical and non-clinical factors. We used data from the BENCH-D study to assess gender-differences in terms of clinical and person-centered measures in T2DM.

Methods: Clinical quality of care indicators relative to control of HbA1c, lipid profile, blood pressure, and BMI were derived from electronic medical records. Ten self-administered validated questionnaires (SF-12 Health Survey; WHO-5 well-being index; Problem Areas in Diabetes (PAID) 5, Health Care Climate Questionnaire, Patients Assessment of Chronic Illness Care, Diabetes Empowerment Scale, Diabetes Self-care Activities, Global Satisfaction for Diabetes Treatment, Barriers to Taking Medications, Perceived Social Support) were adopted as person-centered outcomes indicators.

Results: Overall, 26 diabetes clinics enrolled 2,335 people (men: 59.7%; women: 40.3%). Lower percentages of women reached HbA1c levels < =7.0% (23.2% vs. 27.8%; p = 0.03), LDL-cholesterol < 100 mg/dl (48.3 vs. 57.8%; p = 0.0005), and BMI <27 Kg/m2 (27.2 vs. 31.6%; p = 0.04) than men. Women had statistically significant poorer scores for physical functioning, psychological well-being, self-care activities dedicated to physical activities, empowerment, diabetes-related distress, satisfaction with treatment, barriers to medication taking, satisfaction with access to chronic care and healthcare communication, and perceived social support than men; 24.8% of women and 8.8% of men had WHO-5 < =28 (likely depression) (p < 0.0001); 67.7% of women and 55.1% of men had PAID-5 > 40 (high levels of diabetes-related distress) (p < 0.0001). At multivariate analysis, factors associated with an increased likelihood of having elevated HbA1c levels (≥8.0%) were different in men and women, e.g. having PAID-5 levels >40 was associated with a higher likelihood of HbA1c ≥8.0% in women (OR = 1.15; 95%CI 1.05-1.25) but not in men (OR = 1.00; 95%CI 0.93-1.08).

Conclusions: In T2DM, women show poorer clinical and person-centered outcomes indicators than men. Diabetes-related distress plays a role as a correlate of metabolic control in women but not in men. The study provides new information about the interplay between clinical and person-centered indicators in men and women which may guide further improvements in diabetes education and support programs.

Keywords: Diabetes-related distress; Gender-disparities; Psychological wellbeing; Type 2 diabetes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Between-gender differences in the intermediate outcomes indicators of AMD-Annals
Fig. 2
Fig. 2
Between-gender differences in the prevalence of likely depression (WHO-5 < =28) and high diabetes-related distress (PAID-5 > 40)
See this image and copyright information in PMC

References

    1. TRIAD Study Group The translating research into action for diabetes (TRIAD) study: a multicenter study of diabetes in managed care. Diabetes Care. 2002;25:386–9. doi: 10.2337/diacare.25.2.386. - DOI - PubMed
    1. Saaddine JB, Cadwell B, Gregg EW, et al. Improvements in diabetes processes of care and intermediate outcomes: United States, 1988–2002. Ann Intern Med. 2006;144:465–74. doi: 10.7326/0003-4819-144-7-200604040-00005. - DOI - PubMed
    1. Rossi MC, Nicolucci A, Arcangeli A, Associazione Medici Diabetologi Annals Study Group et al. Baseline quality-of-care data from a quality-improvement program implemented by a network of diabetes outpatient clinics. Diabetes Care. 2008;31:2166–8. doi: 10.2337/dc08-0469. - DOI - PMC - PubMed
    1. Rossi MC, Candido R, Ceriello A, et al. Trends over 8 years in quality of diabetes care: results of the AMD-annals continuous quality improvement initiative. Acta Diabetol. 2015;52:557–71. doi: 10.1007/s00592-014-0688-6. - DOI - PubMed
    1. Giorda CB, Nicolucci A, Pellegrini F, et al. Improving quality of care in people with type 2 diabetes through the associazione medici diabetologi-annals initiative: a long-term cost-effectiveness analysis. Diabet Med. 2014;31:615–23. doi: 10.1111/dme.12366. - DOI - PubMed

Publication types