Authors' recommendations: Serious consequences of type 1 diabetes include long-term adverse effects of hyperglycemia and short-term impacts of hypoglycemic events. Whether through the negative consequences of uncontrolled type 1 diabetes or efforts to avoid them, these patients experience impacts to their physical, emotional, practical, and social quality of life. The impacts on each of these domains are connected: • Physically, people with uncontrolled type 1 diabetes often feel ill, experience cognitive dysfunction, have difficulty maintaining their weight at a desired level, and experience fluctuating moods. Women who are pregnant or breast-feeding may find these physical symptoms exacerbated as their blood sugar level fluctuates more dramatically in response to hormone changes, pregnancy-induced nausea and vomiting, and breast-feeding • Emotionally, patients may feel anxious about long-term consequences of hyperglycemia and short-term consequences of hypoglycemia. Patients with uncontrolled diabetes may also experience frustration, guilt, and powerlessness at their inability to control their diabetes. They may feel alienated from the "normal" world, and the cumulative effect of all of these negative emotions can result in depression • Practically, patients may choose to adhere to very rigid self-management regimens in an effort to control their diabetes. The rigidity of these routines may have negative impacts on the employment and social opportunities available. Patients with uncontrolled diabetes may be reluctant to engage in activities, such as driving or operating heavy machinery, where hypoglycemic episodes could have particularly negative consequences. They may not be able to consistently perform to their best level at work due to rigid self-management routines and the negative physical impacts of hypoglycemia and hyperglycemia; this may result in lost wages and professional opportunities • Socially, patients with uncontrolled diabetes experience several negative impacts on their well-being, including alienation, embarrassment, and stigmatization. These experiences, paired with the need for very rigid self-management routines, may result in withdrawal from social activities. The social consequences of uncontrolled diabetes also affect the family members, who report significant amounts of worry and anxiety about their loved ones with diabetes. Many family members describe changing their own routines and social lives in order to support the needs of their loved ones Even when the serious consequences of type 1 diabetes occur only infrequently, the time and energy spent by patients avoiding these consequences can have negative impacts on their professional, social, and family lives. Also, patients may choose to adjust their own target blood glucose levels, intentionally running high in an effort to prioritize avoiding hypoglycemic events in the short term over avoiding the complications of hyperglycemia in the long term.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.hqontario.ca/Portals/0/Documents/eds/ohtas/fev-pancreas-islet-transplantation-1509-en.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Health Quality Ontario

Contact Address: Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5

Contact Name: EDSinfo@hqontario.ca

Contact Email: OH-HQO_hta-reg@ontariohealth.ca

Copyright: Health Quality Ontario (HQO)