Background factors, long-term complications, quality of life and metabolic control in insulin dependent diabetes.

Sixty-six of 74 adults with Insulin Dependent Diabetes Mellitus (IDDM) examined earlier (1988), were followed up two years later (1990) with the aim of studying the influence of sociodemographic factors, long-term complications and quality of life on metabolic control. It was found that both non-cohabitance and a major discrepancy between quality of life change ratings made prospectively (difference in current QOL ratings made 1990 vs 1988) and retrospectively (assessed in 1990 and covering the same period) were associated with poorer metabolic control, and also that perceived somatic health was linked with better metabolic control. A majority of the persons with a major discrepancy in their quality of life ratings, seen as suggestive of difficulties in their realistically assessing their own life situation, was also found to be non-cohabitant and/or to have incipient nephropathy, indicating these persons to constitute a risk group. In addition, well-regulated subjects were found to rate their bodily health as higher than they did their quality of life, whereas for poorly regulated persons the opposite was the case. The results were seen as pointing to the need of paying special attention clinically to the group of persons characterized here by a major discrepancy in their quality of life change ratings and also as emphasizing the fact that living with IDDM is a balancing act for the individual between satisfying bodily demands to be well-regulated and living in such a way as to perceive quality of life.