QUALITY OF LIFE IN PATIENTS WITH DIABETES MELLITUS

We evaluated the quality of life (QOL) in 268 patients with diabetes mellitus (NIDDM, 250 cases; IDDM, 10 cases; and other type of diabetes, 8 cases) to determine which aspects were adversely affected by the disease. Information concerning life satisfaction, social activities, ability to work, sexual problems and physical symptoms was obtained from a 30-item questionnaire. Clinical characteristics including duration of diabetes, glycemic control, current treatment, obesity, hypertension, hyperlipidemia, macro- and microvascular complications were obtained from medical records. Diminished QOL was most pronounced in patients who had had a long duration of disease, required insulin therapy, and whose health was disturbed by cerebrovascular disease, end-stage renal disease, mono- and autonomic neuropathy. A significant difference in the subdimensional QOL score was noted in life satisfaction, social activities, ability to work, sexual problems and physical symptoms under these circumstances

ASSESSMENT OF DIETARY BEHAVIORS IN PATIENTS WITH DIABETIC NEPHROPATHY

We examined 218 patients with non-insulin-dependent diabetes mellitus to determine which dietary behaviors were affected by diabetic nephropathy. Diabetic ne- phropathy was divided into three clinical stages : normoalbuminuria, microalbuminuria, and overt proteinuria. Information on dietary habits concerning energy intake, protein intake and salt consumption was observed among different levels of nephropathy. Inadequate behavioral lifestyle was most pronounced in patients with microalbuminuria, and whose health was disturbed by high protein intake and high salt consumption. These findings were obtained for the adults, but not for the elderly. Results in this study provide the basic data for dietary intervention for diabetic patients

LIFESTYLE OF PATIENTS WITH DIABETES MELLITUS

We evaluated the lifestyle of 214 patients with diabetes mellitus to deter- mine which aspects were affected by their disease and diabetic complications. Information concerning lifestyle was obtained from 15-item questionnaires, and a total lifestyle score (TLS) was calculated. Clinical characteristics including duration of diabetes, glycemic control, current treatment, obesity, hypertension, hyperlipidemia, and macro- and microvas- cular complications were evaluated. Patients in their 40s had the lowest TLS, and lifestyle factors were strongly associated with glycemic control, ischemic heart disease, and with autonomic neuropathy. Subjects were also divided into two subgroups of equal size based on the median rate of TLS : an adequate lifestyle group and an inadequate lifestyle group. Although degree of excess in caloric intake was similar in these two groups, sodium intake was significantly higher in the inadequate lifestyle group than in the adequate lifestyle group

SMOKING HABIT AND PROGRESSION OF DIABETIC NEPHROPATHY

The effect of cigarette smoking on the progression of diabetic nephropathy was evaluated cross-sectionally in 155 patients with non-insulin-dependent diabetes mel- litus of at least 5 years duration. Forty-four patients had a smoking habit. There was no difference in the duration of diabetes, mean value of HbA1c, or the prevalence of hyperten- sion between the smokers and nonsmokers. However, there was a significant difference in the distribution of a smoking habit among subgroups of diabetic patients with normoal- buminuria, microalbuminuria, and overt proteinuria. Thus, cigarette smoking in patients with diabetes is concluded to be a risk factor for the development of diabetic nephropathy