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Acta Diabetol. 2019 Nov;56(11):1209-1216. doi: 10.1007/s00592-019-01384-9. Epub 2019 Jul 17.

Vision-related quality of life and locus of control in type 1 diabetes: a multicenter observational study.

Author information

1
Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Corso AM. Dogliotti 14, 10126, Turin, Italy. marina.trento@unito.it.
2
Department of Public Health and Paediatric Sciences, University of Turin, Turin, Italy.
3
Endocrinology and Diabetology Unit, Health Unit 1, Savigliano, Italy.
4
Eye Clinic, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy.
5
Endocrinology and Metabolic Diseases Unit, Hospital of Foggia, Foggia, Italy.
6
Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute, Milan, Italy.
7
Department of Ophthalmology, Territorial Ophthalmology, Pescara, Italy.
8
Eye Clinic, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
9
Department of Medical Sciences, University of Turin, Turin, Italy.
10
Laboratory of Clinical Pedagogy, Department of Medical Sciences, University of Turin, Corso AM. Dogliotti 14, 10126, Turin, Italy.

Abstract

AIMS:

Diabetic retinopathy remains asymptomatic until its late stages but remains a leading cause of vision impairment and blindness. We studied quality of life and the ability to deal with the discomfort deriving from the presence of a chronic disease in patients with type 1 diabetes and different stages of retinopathy.

METHODS:

Multicenter collaborative observational study involving nine centers screening for retinopathy in different areas of Italy. The National Eye Institute 25-item visual functioning questionnaire and the locus of control tool were administered to 449 people with type 1 diabetes between February 2016 and March 2018. Socio-demographic and clinical data were collected.

RESULTS:

On multivariable analysis, severe retinopathy is associated with worse scores for general vision, ocular pain, near vision activities, distance vision activities, driving, color vision, peripheral vision and lower values of internal control, independently of visual acuity. Women had a perception of worse general health, distance vision activities and driving, and lower internal control and trust in others. Worse scores for visual-specific social functioning, visual-specific mental health, visual-specific role difficulties, visual-specific dependency and peripheral vision were associated with higher HbA1c levels. Fatalism increased with rising HbA1c levels.

CONCLUSIONS:

These results confirm that a gap exists between patients' knowledge and expectations on retinopathy and providers' expertise and assumptions. To bridge this gap, patient-centered education and engaging approaches may be more effective than simple information given during consultations.

KEYWORDS:

Diabetic retinopathy; People with type 1 diabetes; Quality of life

PMID:
31313005
DOI:
10.1007/s00592-019-01384-9

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