Clinical-Functional and Expert-Rehabilitation Parallels of Disability in the Adult Population Due to Diabetes Mellitus

Abstract

The area of "comprehensive rehabilitation" necessitates the development of rehabilitation programs tailored to specific nosological categories among patients with disabilities. Diabetes mellitus represents one of the most pressing issues in modern society. The effectiveness of rehabilitation measures and the improvement of patients’ quality of life depend on the alignment of applied technologies with the severity of clinical and functional impairments, as well as their progression, which leads to varying degrees of activity limitations.

Objective To assess the degree of activity limitations in individuals with disabilities due to diabetes mellitus, based on their clinical and functional impairments.

Materials and Methods The study was compiled in Excel tables using the following methods: document analysis and data extraction (320 cases). The data prepared for analysis in .xlsx format were uploaded into the R environment. Data processing and analysis were performed using scripts in R. For continuous normally distributed variables, the mean and standard deviation were calculated; comparison between two groups employed the t-test. For continuous non-normally distributed variables, the mean (M) and standard deviation (SD) were calculated, and the p-value of the Student’s t-test (p_t) was used to compare two groups. For non-normally distributed continuous variables, the median (Me), first (Q1), and third (Q3) quartiles were calculated, with the Mann–Whitney U test and its p-value (p_mu) used for group comparisons. For ordinal or numerical paired variables, Spearman's correlation coefficient and its p-value (r (p)) were computed. To identify associations between categorical variables, the Chi-square test for the corresponding contingency tables and its p-value (p(χ²)) were applied. When expected frequencies in some cells were less than 5, Yates’ correction for continuity was used. To illustrate the relationship between binary indicators, correspondence analysis was employed.

Results It was found that among individuals with disabilities due to diabetes mellitus, the most prevalent activity limitations were in self-care and mobility at the first degree of severity, and in work activity and self-care at the second and third degrees.

Conclusion Expert and rehabilitation diagnostics of individuals with disabilities of different age groups and various diabetes-related complications, who underwent medical and social assessment, provide individualized information regarding the necessary scope of rehabilitation interventions in accordance with the International Classification of Functioning, Disability and Health (ICF). Conducting expert-rehabilitation and medical-social diagnostics in this population enables forecasting of diagnostic volumes, disease progression, and the utilization of medical and rehabilitation services.