The Patient-Doctor Relationship and Metabolic Control in Patients with Type 1 (Insulin-Dependent) Diabetes Mellitus

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Abstract
Objective: Our hypothesis was that patient-doctor relationship experienced positively by the patient is associated with adequate compliance behavior and thus to the long-term metabolic control of diabetes. Method: Cross-sectional study of 100 consecutive adult patients with Type 1 diabetes treated in a diabetes out-patient department. From a questionnaire, four scores (direct estimate of physician, satisfaction with the place of treatment, self-esteem score, security with the patient-doctor relationship) determining the patient-doctor relationship were formed. In score 3 (self-esteem score) the impact of the patient-doctor relationship to the patients' self-esteem was indirectly estimated. The anonymous data taken from diabetes register including information about treatment of diabetes, metabolic control and end-organ complications were returned together with the questionnaire. On the basis of GHbA1c diabetic patients were divided into two groups: with adequate metabolic control (GHbA1c ⩽ 8.0%) or with poor/moderate control (GHbA1c > 8.0%). Results: In univariate analyses the score 3 associated with metabolic control ( p < 0.001). In logistic regression analyses the nephropathy ( t = 2.80, p < 0.05) and score 3 ( t = 3.98, p < 0.001) were associated with metabolic control. Conclusion: Patient's positively-experienced patient-doctor relationship was associated with good metabolic control of diabetes.