Gender Satisfaction among Type 2 Diabetes Patients: A Comparison between Intensive Diets, Lifestyle Intervention with Medication Controlled Management

Abstract

Background: Exactly when to initiate insulin in recent onset Type 2 Diabetes Mellitus (T2DM) remains unclear. Emerging evidence suggests that increased physical activity and weight loss can delay or prevent the onset of T2DM, and in some cases normalise blood glucose levels. Aim: The aim of the study is to investigate gender satisfaction of health quality of life at achieving better glycaemic - HbA1c level in patients with T2DM in comparison to intensive dietary and lifestyle interventions with medication controlled management. Subjects and Methods: A cross-sectional comparison study was designed based on 1,386 available participants with diagnosed T2DM at the Primary Health Care (PHC) and Hamad General Hospital in Qatar during the period from November 2012 to June 2014. 1,386 participants were evaluated to get either conventional therapy (dietary restriction) or intensive therapy (metformin, sulfonylurea, sitagliptin) for glucose control. The changes in serum lipid profiles (cholesterol, LDL, HDL), uric acid, blood pressure and glycated hemoglobin (HbA1c) were analysed at baseline and after twelve months. In addition, socio-demographic data was collected and univariate and multivariate statistical analysis was performed. Results: There were statistically significant differences between female and male patients in terms of age (p<0.001), ethnicity (p=0.012), occupation (p<0.001), monthly income (p<0.001), physical exercise (p<0.001), sport activity (p=0.018), cigarette smoking (p<0.001), shisha smoking (p=0.036) and consanguinity (p=0.012). Significantly greater improvements in mean values of blood glucose (-2.50 vs. -2.46; p=0.001), HbA1c (-1.22 vs. -1.21; p=0.001), and cholesterol (-1.51 vs. -0.59; p=0.001) were found in female patients. Reductions in blood glucose, HbA1c, total cholesterol, HDL, albumin, urea triglyceride, and blood pressure systolic and diastolic were found in both genders. Male patients had higher changes in systolic blood pressure (-4.4 vs. -3.9; p<0.001) urea (1.04 vs. -0.83; p<0.001), LDL (-0.13 vs. +0.16; p<0.001) and albumin (-3.56 vs. -3.61; p<0.001) in comparison to females. Conclusion: Current study indicates that intensive lifestyle changes, physical exercise and metformin treatment have favourable effects on patients at high risk for T2DM. Lifestyle modifications based on physical, dietary interventions and medication are associated with improvements in the blood glucose and HbA1c levels in patients with T2DM. Even those with gross glycaemic abnormalities, more than 60% can achieve target glycaemic control using diet, lifestyle and metformin.