The present study concluded that chronic diseases like diabetes affect the quality of life of patients.As the main goal of any medical care is the improvement of the patients’ overall quality of life, the clinical pharmacist imparted patient education through counseling has a major role in improving the physical as well as mental health outcomes.

1. RRJoM (2014) 1-4 © STM Journals 2014. All Rights Reserved Page 1
Research & Reviews: Journal of Medicine
eISSN: 2249-8648, pISSN: 2348-7917
Volume 4, Issue 1
www.stmjournals.com
Effect of Patient Counseling in Improving Physical and
Mental Health of Type-2 Diabetes Mellitus Patients
Amareswara Reddy Gangula*, Gowthami Reddy V, Divyaja M,
Kanala Siva Kumar Reddy, Samjeeva Kumar E
Department of Pharm D, P Rami Reddy Memorial College of Pharmacy, Kadapa,
Andhra Pradesh, India
Abstract
Diabetes mellitus is a heterogeneous metabolic disorder characterized by chronic
hyperglycemia with insulin hypo-secretion or insulin insensitivity. Despite the availability
of treatment, diabetes has remained a major cause of death. The main goal of any
medical care is the improvement of the patients’ overall quality of life. The aim of this
paper was to assess the impact of pharmacist provided patient counseling on physical
and mental health outcomes in type-2 diabetes mellitus. The prospective observational
study was carried out at Rajiv Gandhi Institute of Medical sciences (RIMS), Kadapa.
This study was conducted over a 2-month period from February 2014 to March 2014.
The study population was both men and women if they had uncontrolled type-2 diabetes
mellitus, FBS level > 129 mg/dL and RBS > 200 mg/dL, age group (> 30 years). The
patients meeting the inclusion criteria were asked to fill the SF-12 questionnaire and the
baseline data was obtained. Each patient was counseled regarding their disease,
medications and lifestyle modifications and advised to revisit after one month. Upon their
revisit same questionnaire was again asked to be filled by them and the data obtained
were compared with baseline data collected previously. Out of 200 patients, majority of
patients 168 (84%) answered only physical components, followed by 152 (76%)
answered both physical and mental components, finally 56 (28%) patients answered only
mental components. Upon assessing the physical and mental health functioning of the
patients, there was an improvement in both the components after providing education by
counseling process regarding disease, medication and lifestyle changes. The present
study also concluded that chronic diseases like diabetes affect the quality of life of
patients. As the main goal of any medical care is the improvement of the patients’ overall
quality of life, the clinical pharmacist imparted patient education through counseling has
a major role in improving the physical as well as mental health outcomes.
Keywords: Patient counseling, Type-2 diabetes mellitus, physical and
mental health outcomes
*Author for Correspondence E-Mail: amarpdtr@gmail.com
INTRODUCTION
Diabetes mellitus is a heterogeneous metabolic
disorder characterized by chronic
hyperglycemia with insulin hypo-secretion or
insulin insensitivity [1]. It is one of the oldest
known diseases. An Egyptian manuscript from
1550 BCE mentions the phrase “the passing of
too much urine.” The great Indian physician
Sushruta (6th century BC) identified the
disease and classified it as Medhumeha [2]. In
1776 Matthew Dobson confirmed that the
sweet taste comes from an excess of a kind of
sugar in the urine and blood [3]. The first
complete clinical description of diabetes was
given by the ancient Greek physician Aretaeus
of Cappadocia (1st century) [4], who noted the
excessive amount of urine which passed
through the kidneys and gave the disease the
name “diabetes.” In medieval Persia, Avicenna
(980–1037) provided a detailed account on
diabetes mellitus in The Canon of Medicine,
describing the abnormal appetite and the
collapse of sexual functions, and he
documented the sweet taste of diabetic urine
[5]. The distinction between what is now
known as type-1 diabetes and type-2 diabetes

2. Patient Counseling in Diabetes Mellitus Patients Gangula et al.
RRJoM (2014) 1-4 © STM Journals 2014. All Rights Reserved Page 2
was first clearly made by Sir Harold Percival
(Harry) Himsworth [6], and published in
January 1936. Despite the availability of
treatment, diabetes has remained a major cause
of death. Insulin production and therapy
rapidly spread around the world. Banting is
honored by World Diabetes Day which is held
on his birthday, November 14 [7].
Padilla et al.’s conducted a study on “Quality
of life for patients with diabetes in Korea the
meaning of health-related quality of life.” The
physical impact of diabetes included decreased
energy, limitations, and physical suffering;
while its psychological/spiritual impact
extended to general stress, helplessness, fear,
depression, anger, and relationship with God
[8]. The current study is a randomized
comparative intervention (concurrent control)
and attempts to study the effect of counseling
and education provided by clinical pharmacist
regarding the disease and related issues to
achieve glycemic control to ultimately better
quality of life of diabetic patients. Patient
counseling increased the knowledge about
diabetes and importance of self-care, life style
modifications that can lead to better glycemic
control [9]. Ramesh et al. conducted a study
on “Impact of community pharmacy based
patient education on quality of life in type-2
diabetes mellitus,” which was a prospective,
open label, randomized study in a south Indian
state for nine months to assess the impact of
pharmacist provided patient education on
knowledge, attitude and practice (KAP) and
quality of life in type-2 diabetes mellitus
patients. The study concluded that chronic
diseases like diabetes affect the quality of life
of patients and education has major role in
improving the health care outcomes.
Maintenance of diet and exercise improved the
patient’s enjoyment in day to day life activities
and that has reduced the morbidity and
mortality rate [10].
AIM
To assess the impact of pharmacist provided
patient counseling on physical and mental
health outcomes in type-2 diabetes mellitus.
METHOD
The prospective observational study was
carried out at Rajiv Gandhi Institute of
Medical Sciences (RIMS), Kadapa, an
800-bedded multi-disciplinary tertiary care
teaching hospital. This study was conducted
over 2 months period from February 2014 to
March 2014, for assessing the impact of
patient counseling on the quality of life in
type-2 diabetes mellitus patients.
Inclusion and Exclusion Criteria
The study population both men and women
were included to participate if they had
uncontrolled type-2 diabetes mellitus, FBS
level > 129 mg/dL and RBS > 200 mg/dL, age
group(> 30 years). Patients having end-stage
complications like renal failure, hepatic failure
and cardiac failure or those with history of
drug (or) alcohol abuse were excluded from
the study.
Short Form-12 Questionnaire
The quality of life questionnaire contains 12
questions which measures physical component
summary (PCS), mental component summary
(MCS). Quality of life scales has an additional
advantage of being able to integrate the
positive effect of treatment on disease and the
negative effects of treatment to give “net”
effect in measurable areas. The patients
meeting the inclusion criteria were asked to fill
the SF-12 questionnaire and the baseline data
was obtained. Each patient was counseled
regarding their disease, medications and
lifestyle modifications and advised to revisit
after one month. Upon their revisit, the same
questionnaire was again asked to be filled by
them and the data obtained were compared
with baseline data collected previously.
RESULTS AND DISCUSSION
Here short form-12 was used to assess the
quality of life of patients at baseline and after
counseling, by using physical components
(total of 6 questions in that 2 from physical
functioning, 2 from role physical, 1 from
bodily pain, and 1 from general health) and
mental components (total of 6 questions in that
2 from vitality, 1 from social functioning, 1
from role emotional, 2 from mental health).
Out of 200 patients, majority of patients 168
(84%) answered only physical components,
followed by 152 (76%) answered both
physical and mental components, finally 56
(28%) patients answered only mental
components (Table 1).

3. Research & Reviews: Journal of Medicine
Volume 4, Issue 1
eISSN: 2249-8648, pISSN: 2348-7917
RRJoM (2014) 1-4 © STM Journals 2014. All Rights Reserved Page 3
Physical Health Outcomes
Upon assessing the physical functioning of the
patients, there was an improvement in the
physical components in diabetic patients and
results are shown in Table-2 with p-value.
Mental Health Outcomes
Upon assessing the mental health outcomes of
the patients, there was an improvement in the
mental health of the patients after the
counseling and results are shown in Table 3
with p-value.
Table 1: Table Showing Number of Patients Answered Physical, Mental Components as well as Both.
S. No. Quality of life components No. of patients answered percentage
1 Physical components 168 84%
2 Mental components 56 28%
3 Both 152 76%
Table 2: Assessment of Physical Components.
S. No.
Physical components Average score at
pre-counseling
Average score
at post-
counseling
P-value
1. Physical functioning
0.0088
a Moderate activities 49.00 57.25
b Climb several flights 39.67 63.48
2 Role physical
a Accomplished less 27.63 71.56
b Limited in kind 44.87 64.22
3 Bodily pain
a Pain- magnitude 56.75 48.72
4
General health
EVGFP rating:
a Health excellent 29.56 53.44
Table 3: Assessment of Mental Components.
S. No. Mental components
Average score at
pre-counseling
Average score
at post-
counseling
P-value
1 Vitality
0.0226
a Proper life 33.79 66.75
b Energy 33.54 59.42
2 Social functioning
a Social time 25.68 44.98
3 Role emotional
a Careful about life 58.72 79.94
4 Mental health
a Peaceful 23.12 42.54
b Happy 21.76 40.67
Quality of life is a concept increasingly valued
as an outcome variable in bio-behavioral
research. In this study the authors observed
both statistical and clinical improvement in
quality of life of the patients at baseline and
after counseling and the same was supported
by Ramesh et al. [10] study and Gottipati et al.
[9] study.
CONCLUSIONS
The present study concluded that chronic
diseases like diabetes affect the quality of life
of patients.

4. Patient Counseling in Diabetes Mellitus Patients Gangula et al.
RRJoM (2014) 1-4 © STM Journals 2014. All Rights Reserved Page 4
As the main goal of any medical care is the
improvement of the patients’ overall quality of
life, the clinical pharmacist imparted patient
education through counseling has a major role
in improving the physical as well as mental
health outcomes.
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