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Expectations and fear of diabetes-related long-term complications in people with type 2 diabetes at primary care level

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Abstract

Aims

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.

Methods

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%.

Results

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%).

Conclusion

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.

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Abbreviations

BMI:

Body mass index

DMP:

Disease management programmes

FCQ:

Fear of complications questionnaire

HbA1c:

Glycated haemoglobin

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Authors and Affiliations

  1. Outpatient healthcare centre Dr. med. Kielstein, Erfurt, Germany

    Nadine Kuniss & Volker Kielstein

  2. Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena University Hospital, Am Klinikum 1, 07740, Jena, Germany

    Nadine Kuniss, Nicolle Müller & Ulrich A. Müller

  3. Jena, Germany

    Michael Freyer

Authors
  1. Nadine Kuniss
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  2. Michael Freyer
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  3. Nicolle Müller
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  4. Volker Kielstein
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  5. Ulrich A. Müller
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Corresponding author

Correspondence to Nadine Kuniss.

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Conflict of interest

None. All authors declare that they have no competing interests.

Ethical standard

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

Informed consent was obtained from all patients for being included in the study.

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Managed by Antonio Secchi.

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Kuniss, N., Freyer, M., Müller, N. et al. Expectations and fear of diabetes-related long-term complications in people with type 2 diabetes at primary care level. Acta Diabetol 56, 33–38 (2019). https://doi.org/10.1007/s00592-018-1217-9

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  • DOI: https://doi.org/10.1007/s00592-018-1217-9

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