Advance directives for insulin-using diabetic patients

Little has been written about the use of advance directives by patients with diabetes. We asked 27 insulinusing diabetic outpatients of both sexes (aged 18 to 70 [mean 49] years) to complete a questionnaire on demographic characteristics and their current knowledge of, attitudes about and behaviours regarding advance directives. The patients and their physicians also rated the patients' quality of life using Cantril's SelfAnchoring Striving Scale4 and the patients' state of health on a numeric scale ranging from 1 (excellent) to 5 (poor). Half of the participants were then randomly assigned to participate in an education program on advance directives, which included a discussion and question period with a health care professional, an information pamphlet and a video entitled My Health Care - I Decide.5 Four to 6 weeks later the patients were asked to complete a follow-up questionnaire.