Diabetes Patients More Likely Than Their Doctors to Focus on Immediate, Rather Than Long-Range, Concerns

| Feb 16, 2010

A university survey of 92 doctors and their 1,200 patients who have diabetes and hypertension shows that the two groups don't always agree on which conditions are the most important to manage. The survey, conducted by the University of Michigan Medical School, asked doctors and patients to rank their top treatment priorities. While 38 percent of the doctors ranked treating hypertension as the most important, only 18 percent of their diabetes patients gave it the same ranking. Instead, diabetes patients are more likely to list pain and depression as the most important targets for treatment. In fact, the patients suffering the most from those conditions were the most likely to list them as priorities.

The Michigan researchers, publishing their findings in the Journal of General Internal Medicine, theorized that the difference in perception results from the immediacy of each group's concerns. Doctors, trained to take a long-range view, know that diabetes is often accompanied by conditions that, if left untreated, can result in early death. These include hypertension, cardiovascular problems, and kidney problems, which  doctors are often keen to focus on as early as possible in treating the disease.

But people who have diabetes often have more immediate problems, especially if they were older or in already poor health at the time of their diagnosis. Those problems can include pain from diabetic inflammation or neuropathy and depression from having acquired a progressively debilitating disease. An unfortunate result of those side effects is that patients' preoccupation with them makes it harder for them to effectively manage their disease, including doing the things that their doctors think they should be doing to stave off long-term complications. 

The researchers concluded that both doctors' and patients' points of view are valid. They suggested that because both groups must agree on priorities before they can create effective diabetes treatment plans, concerns about pain and depression should not be treated as "back-burner" items.  

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Diabetes patients rank health concerns differently than their doctors, U-M survey shows

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Categories: Complications & Care, Depression, Diabetes, Diabetes, Heart Care & Heart Disease

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Posted by Marie Sambilay on 27 May 2011

I am waiting for a study that will focus on concerns of long-standing diabetics who have so far managed to ward off the most common complications of diabetes (such as hypertension and heart disease). The subjects would be those who, like me, have had type 1 diabetes for 30 years or more, who are able to manage their diabetes well on a day-to-day basis, and who don't need their PCPs to micromanage them. The study will instead look precisely into those lesser-known complications that not even tight control (by the patient) can prevent, such as neuropathy affecting involuntary muscle systems (such as the digestive system), the bones, and brain function. I've recently had to switch to a different PCP because my former PCP was more obsessed over my fructosamine values than my excellent A1C.

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