Expectations and fear of diabetes-related long-term complications in people with type 2 diabetes at primary care level
The quality report of patients enrolled in the disease management programmes of North Rhine Westphalia 2016 showed prevalence of long-term complications in diabetes type 2: neuropathy 24.2%, nephropathy 12.5%, retinopathy 8.2%. The aim of this study was to assess expectations and fear of diabetes-related long-term complications in people with diabetes type 2.
We assessed expectations and fear of diabetes-related complications in 104 people with diabetes type 2 (age 67.0J, diabetes duration 6.6J, HbA1c 6.6%/48.6 mmol/mol, neuropathy 20.2%, nephropathy 11.5%, retinopathy 1.9%) in an outpatient healthcare centre at primary care level. Fear of diabetes-related complications was assessed using the “Fear of Complications Questionnaire” (FCQ) with a range of 0–45 points (≥ 30 means clinically meaningful fear, higher scores imply higher level of fear). Furthermore, study participants estimated general and personal risk of suffering from diabetes-related long-term complications after 10 years of diabetes duration on a scale of 0–100%.
Mean FCQ score was 22.9 ± 11.5. 34/104 participants (32.7%) scored ≥ 30 points and thus had great fear. Participants estimated general risk of suffering from diabetes-related complications after 10 years of diabetes duration on 55.1% and personal risk on 46.0%. Risk of diabetes-related complications scoring highest was impaired circulation of lower limb (62.1%), eye complications (57.3%) and kidney complications (54.7%).
Prevalence of diabetes-related long-term complications was overestimated in people with diabetes type 2. Approximately one third of the participants showed even great fear. Patient expectation and fear about diabetes-associated complications did not correspondent with data on clinical reality.
KeywordsDiabetes-related complications Fear of complications FCQ
Body mass index
Disease management programmes
Fear of complications questionnaire
Compliance with ethical standards
Conflict of interest
None. All authors declare that they have no competing interests.
The study was conducted in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.
Human and animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
Informed consent was obtained from all patients for being included in the study.
- 1.Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Therapie des Typ-2-Diabetes—Langfassung, 1. Auflage. Version 4. 2013, zuletzt geändert: November 2014. http://www.dm-therapie.versorgungsleitlinien.de. Accessed 06 Feb 2018
- 7.Groos S, Kretschmann J, Macare C, Weber A, Hagen B (2017) Quality assurance report 2016 disease-management-programmes in Northrhine. Available at https://www.kvno.de/downloads/quali/qualbe_dmp16.pdf. Accessed 6 Feb 2018
- 10.Schmitt A, Reimer A, Kulzer B et al (2017) Erfassung von Angst vor diabetischen Folgekrankheiten: Reliabilität und Validität der deutschen Version des Fear of Complications Questionnaire (FCQ). Diabetologie Stoffwechsel 12(S 01):S1–S84Google Scholar
- 11.Bradley C (1994) Diabetes Treatment Satisfaction Questionnaire (DTSQ). In: Bradley C (ed) Handbook of psychology and diabetes: a guide to psychological measurement in diabetes research and practise. Overseas Publishers Association, London, pp 111–132Google Scholar
- 12.World Health Organization, Regional Office for Europe (1998) Use of well-being measures in primary health care—the DepCare project health for all. Target 12. E60246. WHO, GenevaGoogle Scholar
- 15.Hagen B, Altenhofen L, Blaschy S, Groos S, Kretschmann J, Schmidt A (2010) Quality assurance report 2009 disease-management-programmes in Northrhine. Available at https://www.kvno.de/downloads/quali/qualbe_dmp09.pdf. Accessed 6 Feb 2018