Because of better diabetes self-management practices and treatments, people with the condition are living longer than they did 30 years ago. But quality is as important as quantity. What makes quality of life better, and what makes it worse? What would improve your life with diabetes?
What is quality of life?
At its simplest, quality of life (QoL) is another word for satisfaction. In other words, on a scale of 1–100, how good do you think your life is?
Social scientists have developed more objective assessments of quality of life. A typical quality of life scale, like this one, assesses material and financial well-being, health and safety, relationships with other people, social and community connection, personal development, and fulfillment. Other quality of life scales might include the level of independence, the meaning found in life, happiness, and pleasure.
Ultimately, though, precisely measuring quality of life isn’t really that important to us as individuals. What’s important is how we feel about our lives, and how the people in our lives feel, and the impact we’re having on the world.
Quality of life with diabetes
Diabetes can lower your quality of life. You might have chronic pain or fatigue or be dealing with diabetes complications such as sexual dysfunction or vision problems. You might be concerned about the potential for future complications.
Diabetes management can bring up its own quality of life issues. William Polonsky PhD, CDE, Director of the Behavioral Diabetes Institute, says, “Many people become overwhelmed, frustrated, or ‘burned out,’ by the daily difficulties of diabetes and by the unending, often burdensome self-care demands, potentially leading to anger, guilt, depression, fear, [and] feelings of hopelessness.” This condition is sometimes called “diabetes distress.”
Restrictions on eating, the effort of monitoring, the effects of complications, the expense of treatment and supplies, and the need to take medicines can all have negative effects.
How important is glucose control for quality of life?
It may seem natural that having better control of your diabetes would lead to a higher quality of life, but that is not necessarily true. A very long-term study of Americans with diabetes found that people whose doctors aimed for universally tight control lived an average of five weeks longer than those whose doctors were more flexible. But those with looser control had more high-quality time in their lives, again about five weeks.
The authors blamed increased numbers of hypos (low blood sugars) and medication problems for the lower quality seen in tight control. Remember, though, there are other ways of controlling diabetes that don’t necessarily involve lots of medications.
Steps you can take to improve quality of life
If you can get more physical activity, eat lower-carbohydrate foods, and reduce stress, you might find you enjoy life more while having better control. You might also pay attention to the central areas of quality of life described in this article. Briefly:
• Improve the quality and quantity of your social relationships, especially with your family.
• Simplify your diabetes management and your medications if you can.
• Engage in a spiritual practice like religious worship, meditation, prayer, or time spent appreciating nature.
• Seek to find a balance between dependence and independence.
• Take time for pleasures and fun.
• Personally, I recommend music and dogs as two things that tend to raise quality of life.
• Treat depression, the biggest killer of quality of life. It’s worse than any physical symptom. If you feel you might be depressed, do something about it. Get help, exercise, get sunshine, and increase social contact. You can take this short screening test to see if you might be depressed.
Want to learn more about quality of life and diabetes? Read “Keeping Your Quality of Life With Diabetes.”