The effect of diet and physical activity on quality of life, wellbeing and treatment satisfaction, in newly diagnosed Type 2 diabetes

Abstract

Type 2 diabetes impacts upon quality of life. Quality of life is lower in diabetes than in the general population but what happens to quality of life over the first years following the diagnosis is less clear. In addition, Type 2 diabetes is associated with depression and other psychological problems. Diet and physical activity are cornerstones of the management of diabetes. Despite the multitude of benefits these lifestyle changes have, adherence to these interventions is poor with people with Type 2 diabetes experiencing numerous barriers to dieting and exercising. A possible reason for the poor adherence could be that these interventions result in a reduction in quality of life or wellbeing, or reduced satisfaction with their treatment. The aim of this thesis is determine the effects of diet and physical activity interventions on quality of life, wellbeing and treatment satisfaction in newly diagnosed Type 2 diabetes, as well as to explore what changes in quality of life and wellbeing occur in first years following diagnosis. Chapter 1 reviews the current evidence of the changes in quality of life and wellbeing that occur in Type 2 diabetes over time, their associations and how they are effected by lifestyle interventions. Chapter 2 describes the Early ACTvity in Diabetes randomised control trial of lifestyle interventions in early Type 2 diabetes from which the dataset originates. Chapter 3 demonstrates lifestyle interventions delivered in newly diagnosed Type 2 diabetes improve treatment satisfaction and do not affect quality of life and wellbeing. It also demonstrates quality of life and wellbeing are not associated with response. Chapter 4 demonstrates quality of life decline slowly over the first six years following diagnosis of Type 2 diabetes, and that this change is likely part of the normal progression of Type 2 diabetes. It also demonstrates wellbeing does not change over this period and that lifestyle interventions have no lasting effect on quality of life or wellbeing. Chapter 5 brings together the main findings of this thesis and their clinical implications, and provides direction for future work.