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Construct Overview of Diabetes

Please note that this section is an archive and is no longer being updated.

Background

Diabetes is a chronic, progressive condition that causes premature disability and mortality, and is the leading cause of blindness, end-stage renal disease, and non-traumatic limb amputations among working-aged persons.¹ Diabetes affects between 6% and 15% of the population, and half of those cases go undiagnosed.^2-3

VA Relevance

Among the veteran population, the disease affects one in eight VA patients, is one of the leading causes of mortality and morbidity, and accounts for greater than 75,000 hospital admissions each year.^4-5 This life-altering disease requires extensive adaptation and life-style changes, such as constant blood glucose monitoring, dietary restrictions, and weight management. The general frustration and fear from dealing with the disease are significant stressors that affect many health outcomes, including quality of life (QoL) and psychosocial functioning. Therefore, an important aspect of diabetes management is the valid and reliable assessment of such outcomes in diabetes care.

Measurement

The measurement of diabetes first begins with diagnosis. Biological tests used to diagnose diabetes include a fasting plasma glucose test, an oral glucose tolerance test, and a random plasma glucose test. Measurement with the fasting plasma glucose test is the preferred method. After diabetes is diagnosed, clinicians and researchers become interested in the measurement of psychological variables related to the disease.

Researchers and clinician-researchers utilize both generic and disease-specific instruments in the measurement of related variables. Since psychosocial outcomes will not present the same way in all patients with all diseases, and because many indicators of psychosocial functioning are confused with symptoms of the disease itself, the use of a diabetes-specific instrument (either alone or in conjunction with a generic instrument) affords increased measurement sensitivity. A multitude of generic and specific instruments are available to the researcher who wishes to assess diabetes outcomes. Besides being either generic or specific, they differ also in whether they are appropriate for Type I diabetes, Type II diabetes, or both.

Through literature review, METRIC identified five commonly used diabetes-related instruments and ranked them according to number of citations. ⁶ What follows is a brief summary of each instrument and three applicable references (chronological), including the developmental source.

Most Frequently Cited Instruments

1. Problem Areas in Diabetes (PAID)
   [55 Citations]
2. Diabetes Care Profile (DCP)
   [32 Citations]
3. Diabetes Specific Quality of Life Scale (DSQOLS)
   [30 Citations]
4. Diabetes Quality of Life Measure (DQOL)
   [29 Citations]
5. Diabetes Health Profile (DHP)
   [27 Citations]

1. Sherwin RS. Diabetes mellitus. In J.C. Bennett & F. Plum (Eds.), Cecil Textbook of Medicine, 20th ed., 1258-77. Philadelphia: W.B. Saunders;1996.
2. Carney C. Diabetes mellitus and major depressive disorder: An overview of prevalence, complications, and treatment. Depress Anxiety. 1998;7(4):149-57. [Abstract]
3. Rubin RR, Peyrot M. Psychological issues and treatments for people with diabetes. J Clin Psychol. 2001;57(4):457-78. [Abstract]
4. Krein SL, Hayward RA, Pogach L, BootsMiller BJ. Department of Veterans Affairs' Quality Enhancement Research Initiative for Diabetes Mellitus. Med Care. 2000;38(6S):I38-48. [Abstract]
5. VA Office of Research and Development, Health Services Research and Development Service. Diabetes: Managing a High-Risk Disease. QUERI Quarterly. 2000;2(2). Available URL: http://www.va.gov/resdev/queri.htm.
6. ISI Web of Knowledge, Accessed January 2005. Available URL: http://isi01.isiknowledge.com/portal.cgi/wos/.