Survey: Diabetics unphased by dangers

By BRUCE SYLVESTER, UPI Science News  |  June 16, 2002 at 5:50 PM
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SAN FRANCISCO, June 16 (UPI) -- Most people with diabetes show a lack of concern about long-term complications associated with the disease, a new survey released Sunday indicates.

The International Diabetes Federation-Europe and Lions Clubs International Foundation reported the survey results at the annual meeting of the American Diabetic Association. The two groups sponsored the survey of 2702 patients in Europe and the United States.

Three-quarters of all diabetics will develop microvascular complications such as diabetic neuropathy, nerve damage that can lead to amputation, as well as diabetic retinopathy, a degenerative eye condition that can cause blindness, or diabetic nephropathy, kidney damage that can lead to kidney failure.

Diabetes is the leading cause of blindness, kidney failure and non-traumatic, lower-leg amputations in working-age adults.

"Diabetes is a monster that keeps moving, often silently, its terrible long-term consequences," said Helmut Henrichs, medical director of the International Diabetes Federation-Europe. "It used to be diabetic coma that was at the forefront of clinical concern. Now we are living longer, and the focus has shifted to the devastating long-term complications, which can often be prevented or delayed," he said. "Clearly, our challenge is to transform the energies of denial or fatalism into daily self-care and large-scale changes in attitudes about managing complications of the disease."

Sixty percent of the subjects surveyed indicated no concern about the possibility of going blind or losing a limb. Over 40 percent indicated problems due to diabetes will happen no matter what preventative measures they take. Thirty percent said they found it difficult to control their diabetes, and 25 percent indicated they were not taking proper measures to manage their disease adequately. Seventy percent of the subjects were unable to provide their last hemoglobin HbA1c level -- a test measuring long-term blood glucose control.

The survey was conducted in six countries, including France, Germany, Italy, Spain, the United Kingdom and the United States. Highlights include:

-- American and British diabetics, by 82 percent and 70 percent, respectively, indicated a desire for more effective treatments of diabetes-related complications, while only 39 percent of German subjects expressed this desire. The survey suggested that, as a group, German diabetics have less concerns about complications.

-- American diabetics revealed the highest rate of daily blood glucose monitoring at 75 percent, while Spanish and French diabetics admitted the lowest daily testing rates.

-- Compared to Italian diabetics, at 36 percent, Spanish at 33 percent and Germans at 30 percent, 64 percent of French respondents said long-term complications will occur no matter what preventative efforts are taken.

-- Eighty-two percent of American and British diabetics said they had undergone professional foot exams in the past year. In contrast, 34 percent of Italian diabetics and 25 percent of Spanish diabetics said they had such exams in the last year. Sixty-six percent of American diabetics self-examined their feet daily, compared with 38 percent in the United Kingdom, 17 percent in Italy and 31 percent in Spain.

"Denial and fatalism show up at high rates among people living with diabetes," said James Gavin III, senior scientific officer and director of the Howard Hughes-National Institutes of Health Research Scholars Program at Howard Hughes Medical Center in Chevy Chase, Md.

"This major survey supports what any clinician can see on a daily basis in practice," Gavin said. "However, it also tells us something positive that we also know, that a majority of patients really do want better treatments for the complications of their disease."

Gavin added, "We need to extend that desire into genuine and proactive self-care, such as getting regular screenings for signs of complications, which can start very silently. It's one thing to want better treatments for complications that are already happening. It's another to believe that these complications can be delayed and even avoided -- and to deal with diabetes out of that belief."

World Health Organization statistics show diabetes is a leading causes of death worldwide. About 150 million people are diabetic and experts expect the number to rise to 300 million by 2025.

Eli Lilly and Company provided an unrestricted grant used by the sponsors to cover expenses related to the survey.

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