Tuesday, April 3, 2012

Patient Surveys: Day 11

Today was the eleventh day of surveying patients. Below are the compiled results of all of my trials thus far.



Of the five patients that I interviewed today, four are Type 2 diabetics. Patients 22, 23, and 25 all presented with very low PHQ-9 scores, relatively normal HbA1c levels, and have Type 2 diabetes. Thus far, their data is characteristic of Type 2 diabetics' tendency to have lower HbA1c levels and PHQ-9 scores than their Type 1 diabetic counterparts. Of course, this observed 'tendency' is just conjecture, as are essentially all of these preliminary observations; I am merely pointing out that Patients 22, 23, and 25's data reflect nothing new or erratic.

On the other hand, I think it is just as important to examine some of the inconsistencies with previously noted trends. Patient 21 is a Type 1 diabetic with a relatively normal HbA1c, 7.30%. Yet, their PHQ-9 score is 9, just one point short of a diagnosis of a DSM-IV depressive disorder. Patient 24 is a Type 2 diabetics with a PHQ-9 score of 0. But their HbA1c level is a very high 13.60% (see Figure 5). This means that the highest HbA1c that I have recorded to date belongs to a Type 2 diabetic (when previously, all of the very high HbA1c levels that I recorded belongs to Type 1 diabetics). Additionally, a patient who is on the verge of depression can still maintain such good control of their diabetes.

These interviews that I conduct consist of merely surveying the patients with a set list of questions. As much as I would like to inquire more from the patient in the event that such inconsistencies arise, I wouldn't know where to begin. Perhaps a recent personal development over the last two weeks (PHQ-9 asks "Over the last 2 weeks, how often have you been bothered by any of the following problems?") resulted in a high PHQ-9 score that would have been far lower had I surveyed the patient a month ago. And maybe, as simplistic as this may sound, Patient 24 has chronically poor habits, from inconsistent glucose monitoring to unhealthy eating; the reason they're not depressed may be simply be because Patient 24 is more comfortable with their inactive lifestyle. After all, not all unhealthy people want to change their ways.

Lalani.

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