Expectations and fear of diabetes-related long-term complications in people with type 2 diabetes at primary care level.

Aims: The quality report of patients enrolled in the disease management programmes of North Rhine Westphalia 2016 showed prevalence of long-term complications in diabetes type 2: neuropathy 24.2%, nephropathy 12.5%, retinopathy 8.2%. The aim of this study was to assess expectations and fear of diabetes-related long-term complications in people with diabetes type 2.

Methods: We assessed expectations and fear of diabetes-related complications in 104 people with diabetes type 2 (age 67.0J, diabetes duration 6.6J, HbA1c 6.6%/48.6 mmol/mol, neuropathy 20.2%, nephropathy 11.5%, retinopathy 1.9%) in an outpatient healthcare centre at primary care level. Fear of diabetes-related complications was assessed using the "Fear of Complications Questionnaire" (FCQ) with a range of 0-45 points (≥ 30 means clinically meaningful fear, higher scores imply higher level of fear). Furthermore, study participants estimated general and personal risk of suffering from diabetes-related long-term complications after 10 years of diabetes duration on a scale of 0-100%.

Results: Mean FCQ score was 22.9 ± 11.5. 34/104 participants (32.7%) scored ≥ 30 points and thus had great fear. Participants estimated general risk of suffering from diabetes-related complications after 10 years of diabetes duration on 55.1% and personal risk on 46.0%. Risk of diabetes-related complications scoring highest was impaired circulation of lower limb (62.1%), eye complications (57.3%) and kidney complications (54.7%).

Conclusion: Prevalence of diabetes-related long-term complications was overestimated in people with diabetes type 2. Approximately one third of the participants showed even great fear. Patient expectation and fear about diabetes-associated complications did not correspondent with data on clinical reality.