People with type 2 diabetes who report good self-management behavior have a reduced mortality risk. This was the result of a population-based study conducted by scientists at Helmholtz Zentrum München emphasizing the great importance of patient behavior in the diabetes treatment process. These findings were published in the journal Diabetes Care.
Scientists of the Institute of Health Economics and Health Care Management (IGM) and of the Institute of Epidemiology II (EPI II) at Helmholtz Zentrum München (HMGU), together with colleagues of the German Diabetes Center (DDZ) in Düsseldorf, investigated the association between self-management behavior and mortality in patients with type 2 diabetes. HMGU and the DDZ are partners in the German Center for Diabetes Research (DZD).
High self-management index – low mortality
340 study participants with type 2 diabetes were interviewed with regard to their patient behavior – e.g. regular monitoring of blood glucose levels, having a diet plan or performing physical exercise. Based on this data a self-management index was defined. The team led by Professor Rolf Holle and Michael Laxy correlated the index with the mortality of the participants, who were monitored over a period of 12 years. The analysis showed that patients with good diabetes self-management, that is patients with a high self-management index, had a significantly lower mortality risk than patients with a low self-management index. This association exists independent of other factors that can influence mortality, such as age, sex, comorbidities or medication.
Active participation of the patient in the treatment is important
“The results show that in addition to physician delivered treatment according to medical guidelines, the patient’s behavior is also of great significance for the course of the disease and for the success of the treatment process “, said Holle, group leader of the research group Economic Evaluation at the IGM. “Patient-centered services, such as diabetes education, self-management training and information services therefore make a valuable contribution to good patient care and should continue to be expanded.”
The basis of the analyzed data is the KORA*- A study, which is composed of participants of two previous population-based health surveys and of the KORA Myocardial Infarction Registry from the Augsburg area.
Diabetes affects nearly ten percent of the population in Germany. The aim of Helmholtz Zentrum München is to develop new approaches to diagnosis, treatment and prevention of common diseases.
* For more than 20 years, the research platform Cooperative Health Research in the Augsburg Region (KORA) has been collecting and analyzing data on the health of thousands of people living in the Augsburg region. The objective is to elucidate the effects of environmental factors, behavior and genes. KORA focuses on the development and course of chronic diseases, in particular myocardial infarction and diabetes mellitus. Risk factors are analyzed with regard to individual health behavior (e.g. smoking, diet, exercise), environmental factors (e.g. air pollution, noise) and genetics. From the perspective of health care research, questions regarding the utilization of health care resources and the cost of health care are also studied.
The Association Between Patient-Reported Self-Management Behavior, Intermediate Clinical Outcomes, and Mortality in Patients With Type 2 Diabetes: Results From the KORA-A Study, Michael Laxy, Andreas Mielck, Matthias Hunger, Michaela Schunk, Christa Meisinger, Ina-Maria Rückert, Wolfgang Rathmann and Rolf Holle, Diabetes Care, DOI: 10.2337/dc13-2533, published online 25 March 2014.