Adult Diabetes and Quality of Life, Psychosocial Issues, and Sexual Health

This chapter focuses on how diabetes impairs health-related quality of life (HRQL) among those with this condition. Epidemiologic studies show that a large proportion of individuals with either type of diabetes (type 1 or type 2) are at risk of suffering significant decrements in dimensions of HRQL, including symptom distress such as excessive thirst, frequent urination, fatigue, and neuropathies; functional limitations; restrictions in normal activities; work limitations; poor general health; depression; anxiety; and social withdrawal that are directly or indirectly caused by diabetes. In addition, the daily burden of self-managing diabetes with lifestyle and medical therapies may significantly reduce HRQL. A focus on diabetes and HRQL in public health is essential to: (1) develop, or propose, models for health care systems that may effectively support diabetes “survivorship” issues; (2) provide a focus on preventing avoidable negative health outcomes with diabetes, both by controlling disease progression and by supporting patient needs at all points along the continuum of care; and (3) more appropriately weigh the true cost of diabetes and its treatment options to patients and to society, and in doing so identify effective preventive and therapeutic regimens that produce the largest momentum toward improved well-being.