RT Journal
A1 Adelman MD
T1 GLycemic control and quality of life in patients with type 2 diabetes
JF JAMA
JO JAMA
YR 1999
FD June 2
VO 281
IS 21
SP 1985
OP 1986
DO 10-1001/pubs.JAMA-ISSN-0098-7484-281-21-jbk0602
UL http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-281-21-jbk0602
AB 
To the Editor: The article by Drs Testa and
Simonson1 on health outcomes during improved glycemic
control had some interesting, unexplained findings that raise the
question of a negative impact of the trial on the placebo group. The
percentage of employed patients who missed 0.5 or more days of work
increased from 2.4% at baseline to 10.5% at the end of week 15 in the
placebo group, compared with a decrease of 5.6% to 4.8% in the
treated group. Per 500 days worked, the total days absent increased
from 4.2 to 24 in the placebo group and decreased from 9.4 to 5.0 in
the treated group. Bed-days (rates per 1000 person-days) had the same
pattern: 921 at baseline to 1843 at the end of week 15 in the placebo
group and 1653 to 1539 in the treated group. Most of the benefit
attributed to improved glycemic control occurred because of worsening
in the placebo group. Also, the placebo group had a decline in
cognitive function, general perceived health, and symptom distress,
while the degree of glycemic control remained the same. The authors
suggest this indicates a cumulative effect of poor glycemic control on
quality of life. Such an outcome might have occurred because more
patients in the control group were newly diagnosed with diabetes. The
duration of diabetes appeared to be the same in both groups and seemed
to indicate that the number of patients with a new diagnosis of
diabetes would have been the same in both groups.