Diabetes Treatment-related Quality of Life is Associated with Levels of Self-care Activities in Insulin Injection Among Japanese Patients with Type 2 Diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 8)

Aims: We investigated the association between diabetes treatment-related quality of life (QOL) and levels of self-care activities in insulin injection among Japanese patients with type 2 diabetes.

Methods: Data from 1394 patients with type 2 diabetes on insulin therapy were obtained from a diabetes registry in Japan. We used the Diabetes Therapy-Related QOL (DTR-QOL) questionnaire and relative risk regression analysis to assess the independent association of high levels of self-care activities in insulin injection and DTR-QOL scores while adjusting for possible confounders.

Results: The mean age, BMI and HbA1c level were 65.8 years, 24.8 kg/m(2) and 62 mmol/mol (7.8 %), respectively. The frequency of insulin injection omission was associated with DTR-QOL scores. In the multivariable-adjusted model, the relative risks for high levels of self-care activities in insulin injection was 1.15 (95 % confidence interval, 1.05-1.26) in the highest quintile compared with those in the lowest quintile of DTR-QOL scores. Subgroup analysis confirmed this association in patients <65 years.

Conclusions: DTR-QOL was associated with self-reported levels of self-care activities in insulin injection, particularly among Japanese patients <65 years with type 2 diabetes. DTR-QOL might be a useful tool to identify patients who consequently omit insulin. For patients with low DTR-QOL score, healthcare providers should discuss their treatment-related problems to prevent insulin injection omission.