Browsing by Autor "A Pumar"
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Item type: Item , Gender Differences In Quality Of Life In Adults With Long-Standing Type 1 Diabetes Mellitus(Research Square (United States), 2020) Ana María Castellano-Guerrero; Raquel Guerrero‐Alba; Desireé Ruiz-Aranda; Sofía Perea; A Pumar; F. Relimpio; Miguel Ángel Mangas; Fernando Lizcano; Maria Asunción Martínez‐BroccaAbstract Background: To assess gender differences in Quality of life (QoL) and in sociodemographic, clinical and psychological factors associated with impaired QoL in adults with long-standing type 1 diabetes mellitus (DM1). Methods: Cross-sectional evaluation in a random cohort of DM1 adult patients from a tertiary care hospital. QoL was evaluated using translated and validated self-administered Diabetes QoL questionnaire (Es-DQoL), and results transformed into a 0-100 scale. Psychological assessment included a planned psychological interview and self-reported questionnaires (Beck Depression Inventory II, State-Trait Anxiety Inventory Form Y, Fear of hypoglycaemia Scale, Medical Outcomes Study Social Support Survey). Results: A total of 312 patients (51.6% male; 38.2 ± 12.7 years; HbA 1c 7.5 ± 1.1% (58.5 ± 14.2 mmol/mol); 20.4 ± 12.0 years of DM1) were included in the analysis. Male and female subgroups showed similar sociodemographic and diabetes-related features and comparable social support. Among female patients, higher frequency of depression [31.7% (IC95% 26.2-40.8) vs. 14.9% (IC95% 10.1-20.8), p<0.05] and anxiety [23.2% (IC95% 19.3-33.14) vs. 13.0% (IC95% 8.1-18.4), p<0.05] and severity of depressive and anxious symptoms were also found. Compared to male patients, female patients showed lower QoL [75 (IC95% 73.6-77.5) vs. 80 (IC95% 75.7-83.1), p<0.05] and scored significantly worse in subscale Diabetes-related worries [69 (IC95% 50-81) vs. 75 (IC95% 72.9-79.0), p<0.05]. Fear of hypoglycemia and severity of depressive and anxious symptoms and were factors independently associated to lower QoL in men and women while high frequency of glycemic excursions was a female-specific predictive one. Conclusions: Adult women with long-standing DM1 showed lower QoL probably related to higher frequency and severity of psychopathological syndromes. Depressive and anxious symptoms and, among women, exposure to glycemic excursions were identified as modifiable, QoL-related variables. Educational, technological and psychological interventions are needed in order to improve QoL in DM1 patients.Item type: Item , Predictive Factors of Quality of Life in Adults with Long-standing Type 1 Diabetes Mellitus(Research Square (United States), 2020) Ana María Castellano-Guerrero; Raquel Guerrero‐Alba; Desireé Ruiz-Aranda; Sofía Perea; A Pumar; F. Relimpio; Miguel Ángel Mangas; Fernando Lizcano; Maria Asunción Martínez‐BroccaAbstract Background: To determine gender differences in Quality of life (QoL) perception and to identify sociodemographic, clinical and psychological characteristics associated with impaired QoL in adults with long-standing type 1 diabetes mellitus (DM1). Methods: Cross-sectional evaluation in a random cohort of DM1 adult patients from a tertiary care hospital. QoL was evaluated using translated and validated self-administered Diabetes QoL questionnaire (Es-DQoL), and results transformed into a 0-100 scale. Psychological assessment included a planned psychological interview and self-reported questionnaires (Beck Depression Inventory II, State-Trait Anxiety Inventory Form Y, Fear of hypoglycaemia Scale, Medical Outcomes Study Social Support Survey). Results: A total of 312 patients (51.6% male; 38.2 ± 12.7 years; HbA 1c 7.5 ± 1.1% (58.5 ± 14.2 mmol/mol); 20.4 ± 12.0 years of DM1) were included in the analysis. Male and female subgroups showed similar sociodemographic and diabetes-related features and comparable social support. Among female patients, higher frequency of depression (31.7% vs. 14.9%, p<0.05) and anxiety (23.2% vs. 13.0%, p<0.05) and severity of depressive and anxious symptoms were also found. Compared to male patients, female patients showed a lower perception of QoL (75 [65-85] vs. 80 [69-87], p<0.05) and scored significantly worse in subscale Diabetes-related worries (69 [50-81] vs. 75 [62-88], p<0.05). Fear of hypoglycemia and severity of depressive and anxious symptoms, as well as the presence of macrovascular complications and high frequency of glycemic excursions were predictive factors of QoL. Conclusions: Adult women with long-standing DM1 showed a worse QoL perception probably related to higher frequency of psychopathological syndromes. Exposure to glycemic excursions and depressive and anxious symptoms were identified as modifiable, QoL-related variables. Educational, technological and psychological interventions aimed at reducing glycemic variability and improving psychological status are needed in order to improve QoL in DM1 patients.