Miguel Constante

health-related quality of life in type 1 and type 2 diabetic patients in a Portuguese central public hospital

Background Diabetes mellitus is a chronic metabolic disease, the prevalence of which has registered a considerable increase, mainly in adults and elderly. The purpose of this study was to assess the relationship between health-related quality of life in patients with diabetes and sex, body mass index, type of diabetes and treatment regimens (type 1 diabetes: intensive versus conventional treatment; type 2 diabetes: insulin use versus non-insulin use), and duration of diabetes. Methods One hundred and twenty-four patients with diabetes were interviewed. Health-related quality of life was evaluated using the age-adjusted Short-Form 36 dimensions (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health), and related to demographic and clinical variables. Independent samples t-tests and One-Way Analysis of Variance were used to compare means of independent samples. The degree of association between pairs of variables was measured by Pearson’s (r) or Spearman’s (rs) correlation coefficients. Results The mean age of the study population was 55.7±16.4 years; 54.8% were male, and 77.4% had type 2 diabetes. Females reported worse quality of life than males in all dimensions of the Short-Form 36, except for role-physical and bodily pain. Obese patients had worse physical functioning than normal weight and overweight patients, and worse vitality than their normal weight counterparts. Type 2 diabetic patients taking insulin had lower physical functioning and vitality than those without insulin therapy. Longer duration of diabetes was associated with lower physical functioning, role-physical, general health, vitality, role-emotional, and mental health. Conclusion Being female, obese, having type 2 diabetes and taking insulin, and having a longer disease duration are characteristics associated with worse age-adjusted quality of life in patients with diabetes.

Relationship between chronic complications, hypertension, and health-related quality of life in Portuguese patients with type 2 diabetes

Background The aim of this study was to assess the relationship between health-related quality of life (HRQoL) and the presence or absence of hypertension and diabetes-related chronic complications in type 2 diabetes, and also the association between HRQoL and the number of chronic complications. Methods One hundred patients with type 2 diabetes were interviewed. HRQoL was evaluated using the age-adjusted Short-Form 36 dimensions (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health). Results The mean age of the study population was 62.7±8.7 years; 54.0% were male, and 51.0% were receiving only oral hypoglycemic agents. Chronic complications were related to worse HRQoL in different dimensions: peripheral neuropathy and cardiovascular disease (all, except bodily pain), retinopathy (physical functioning, general health, vitality, and mental health), peripheral arterial disease (physical functioning, role-physical, and general health), and nephropathy (general health and vitality). Hypertension was related to worse general health and vitality. An increased number of chronic complications was associated with worse HRQoL in all dimensions of Short-Form 36 except for the bodily pain dimension. Conclusion The presence and increased number of diabetes-related chronic complications, and the presence of hypertension were related to worse age-adjusted HRQoL. Peripheral neuropathy and cardiovascular disease were more strongly related to age-adjusted HRQoL.

CO030. RELAÇÃO ENTRE A QUALIDADE DE VIDA NA NEFROPATIA DIABÉTICA COM O SEXO, COMORBILIDADES E EXERCÍCIO FÍSICO

Introducao: A utilizacao da PTH intra-operatoria (PTHio) durante a cirurgia cervical de doentes com hiperparatiroidismo primario (HTP) tem-se generalizado nas ultimas duas decadas. Possibilita uma abordagem cervical minimamente invasiva ao permitir monitorizar o sucesso da intervencao. Objetivo: Correlacionar a descida da PTHio com o sucesso a longo prazo do tratamento cirurgico de doentes com HTP. Metodos: Durante 10 anos, 137 doentes consecutivos com diagnostico de HTP foram operados e a PTHio foi medida antes e 5, 10, 20 e 30 minutos apos excisao da glândula paratiroideia suspeita. A cirurgia foi considerada com sucesso sempre que se verificou descida da PTHio superior ou igual a 50% 10 minutos apos a excisao. Foram definidos 2 grupos – com PTHio normal (grupo I) e acima do normal (grupo II) apos 10 minutos. O material excisado foi enviado para analise anatomo-patologica. Os niveis sericos de calcio e PTH foram monitorizados aos 1.5, 3, 6 e 12 meses de follow-up. Foi efectuada analise estatistica com o programa SPSS versao 20.0 para Windows. A amostra era constituida predominantemente por mulheres (78%), com idade media 61 ± 16 anos. Cerca de 97% dos doentes cumpriam o criterio estabelecido de descida da PTHio aos 10 minutos. Destes, 67% tinham PTH com valor normal e os restantes com valor acima do normal. Resultados: O grupo II apresentava peso das gândulas excisadas, valor maximo de calcio pre-operatorio e PTHio aos 10 minutos signif icativamente mais elevados (p < 0,01). Aos 6 meses de follow-up os valores de PTH eram significativamente inferiores no grupo I e maior proporcao destes doentes apresentava calcio e PTH normais (p < 0,05). Aos 12 meses, a taxa de recorrencia era de 3,7% (doentes do grupo II). Conclusao: A normalizacao da PTH durante a cirurgia, para alem do criterio de descida de 50%, e um factor preditivo de cura no HTP.