WELL-BEING AND TREATMENT SATISFACTION IN OLDER-PEOPLE WITH DIABETES

OBJECTIVE - To measure well-being and treatment satisfaction and their correlates in older people with diabetes. RESEARCH DESIGN AND METHODS - A postal survey was conducted of 1,000 diabetic patients aged great er than or equal to 60 years, representing 56% of the resident older d iabetic population in an inner-city health district with a largely ind igenous population of 230,000 people and a widely varied socioeconomic mix. Well-being and treatment satisfaction were measured with diabete s-specific instruments and correlated with patient data held in a cent ral register. RESULTS - There was an 81% response. The general well-be ing scores (median [interquartile range]) for patients on diet alone, tablets, and insulin were 54 (44-60), 53 (42-61), and 48 (35-56) (P < 0.001 comparing insulin with diet and tablets) compared with a scale m aximum of 66. Treatment satisfaction scores were 35 (31-36), 35 (32-36 ), and 34 (30-36) (P < 0.001 comparing insulin with diet and tablets), scale maximum 36. Mean HbA(1c) concentrations were 5.0 +/- 1.4% (for patients on diet alone), 5.8 +/- 1.6% (tablets), and 6.6 +/- 1.7% (ins ulin) (P ( 0.001 for each difference). Neither well-being nor treatmen t satisfaction correlated with HbA(1c). insulin-treated patients were younger and had been diabetic longer than non-insulin-treated patients : their well-being remained slightly, but significantly, lower when ad justed for age, sex, BMI, and diabetes duration, but treatment satisfa ction was no longer significantly different. Women had lower well-bein g than men. CONCLUSIONS - It has proved possible to measure well-being and treatment satisfaction in a large community-based samples of olde r people with diabetes. At the level of glycemic control in this popul ation, neither parameter correlated with HbA(1c) The lower well-being in insulin-treated patients remained significant in multivariate analy sis.