Letter to the Editor in response to the article ‘The impact of apathy on glycemic control in diabetes: A cross-sectional study’

Abstract

The recent findings of Padala et al. provide an important insight into one potential barrier to achieving good glycemic control [ [1] Padala P.R. Desouza C.V. Almeida S. Shivaswamy V. Ariyarathna K. Rouse L. et al. The impact of apathy on glycemic control in diabetes: A cross-sectional study. Diab. Res. Clin. Pract. 2008; 79: 37-41 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar ]. Their cross-sectional study reports a high prevalence (61.7%) of clinically significant apathy amongst people with diabetes, which may impact on their motivation to adhere to the self-care behaviours that influence diabetes control; for example, the following of an exercise plan or taking insulin as instructed. Padala et al. report that apathy was associated with a significantly higher body mass index (BMI) and HbA1c level; indeed, HbA1c was 0.66% higher in those patients displaying apathy compared with non-apathetic patients (p = 0.08) [ [1] Padala P.R. Desouza C.V. Almeida S. Shivaswamy V. Ariyarathna K. Rouse L. et al. The impact of apathy on glycemic control in diabetes: A cross-sectional study. Diab. Res. Clin. Pract. 2008; 79: 37-41 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar ]. We already know from the United Kingdom Prospective Diabetes Study (UKPDS) that every 1% rise in HbA1c levels increases the risk of micro- and macrovascular complications [ [2] UK Prospective Diabetes Study (UKPDS) Group Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998; 352: 837-853 Abstract Full Text Full Text PDF PubMed Scopus (18813) Google Scholar ]. So, while this cohort was small and comprised mainly white, male veterans with diabetes, the issues it highlights have far-reaching implications.