Good continuity of care may improve quality of life in Type 2 diabetes

Some features of diabetes care and diabetes treatment regimen which may have an impact on health-related quality of life (HRQOL) in people with diabetes were studied cross-sectionally using the SF-20 questionnaire. Of the 381 subjects with Type 2 diabetes aged under 65 years, 260 (68%) participated in the study. On univariate analysis, HRQOL was associated with regular clinical review (check-up at least twice a year) and continuity of care (the same GP for at least 2 years), education by a diabetes nurse, and satisfaction with diabetes education. No associations were found between the HRQOL dimensions and home glucose monitoring, participation in educational courses, or satisfaction with care. On logistic regression analysis only good continuity of care was significantly associated with the better well-being dimensions of the SF 20 (ORs 2.5-6.0). However, good continuity of care was also associated with less satisfactory glucose control (HbA(1c) 8.9 +/- 2.0 (+/- SD) vs 8.3 +/- 2.0%, P=0.04). It is concluded that a permanent physician-patient relationship may improve HRQOL in subjects with Type 2 diabetes, but further prospective studies are needed to confirm this finding.