Bakgrund: Glykemisk kontroll hos personer med typ 1 diabetes kräver stöd och utbildning av vårdpersonal inom diabetesvården. För att förbättra behandlingsresultat och livskvalitet samt minska risken för komplikationer kan intensiva behandlingsstrategier användas för att sträva efter optimal glykemisk kontroll och hälsa. Syfte: Syftet är att beskriva hur intensivbehandling påverkar HbA1c och hälsa hos personer med diabetes typ 1. Metod: En retrospektiv studie, deskriptiv design med kvantitativ ansats. Urvalet skedde från en diabetesmottagning och utgick från redan insamlade data från ett intensivbehandlingsprojekt. 42 patienter med diabetes typ 1 och HbA1c ≥70 mmol/mol inkluderades i intensivbehandlingsprojektet. De variabler som undersöktes var HbA1c och EQ-VAS, för att undersöka sambandet mellan glykemiskkontroll och skattad hälsa. Huvudresultat: Resultatet visade ett svagt samband mellan sjunkande HbA1c och stigande EQ-VAS vid uppföljningen. Det starkaste signifikanta sambandet sågs i kategorin kontakt med dietist, kopplat till HbA1c och EQ-VAS. I kategorierna patienter med flerdosbehandling av insulinpenna, behandling med insulinpump samt utebliven kontakt med dietist visade inget signifikant samband kopplat till sjunkande HbA1c och stigande EQ-VAS.  Slutsats: Studien visar betydande förbättringar i både HbA1c och EQ-VAS hos patienter med diabetes typ 1 efter intensivbehandling. Positiva samband observerades mellan insulinpumpbehandling och högre EQ-VAS, samt dietistkontakt och minskat HbA1c. Fynden tyder på att intensivbehandlingen, särskilt med dietistrådgivning, effektivt förbättrar glykemisk kontroll och livskvalitet. Ytterligare forskning behövs för att bekräfta dessa resultat. / Background: Glycemic control in individuals with type 1 diabetes requires support and education from diabetes care professionals. To improve treatment outcomes and quality of life while reducing the risk of complications, intensive treatment strategies can be employed to achieve optimal glycemic control and health. Purpose: The purpose is to describe how intensive treatment affects HbA1c and health in individuals with type 1 diabetes. Method: A retrospective study with a descriptive design using a quantitative approach. The sample was selected from a diabetes clinic and relied on previously reported data from an intensive treatment project. 42 patients with type 1 diabetes and HbA1c ≥70 mmol/mol were included in the intensive treatment project. Data were analyzed using Spearman's rank correlation analysis to identify relationships between HbA1c and health. Main Results: The results showed a weak correlation between decreasing HbA1c and increasing EQ-VAS scores at follow-up. The strongest significant correlation was observed in the category of contact with a dietitian, linked to HbA1c and EQ-VAS. In the categories of patients using multiple daily injections with insulin pens, insulin pump therapy, and lack of contact with a dietitian, no significant correlation was found related to decreasing HbA1c and increasing EQ-VAS. Conclusion: The study shows significant improvements in both HbA1c and EQ-VAS in patients with type 1 diabetes after intensive treatment. Positive correlations were observed between insulin pump therapy and higher EQ-VAS scores, as well as between dietitian contact and reduced HbA1c. The findings suggest that intensive treatment, especially with dietitian counseling, effectively enhances glycemic control and quality of life. Further research is needed to confirm these results.

This thesis examined the sensitivity of the EQ-5D-5L instrument in measuring health-related quality of life (HRQoL) among patients with persistent symptoms following COVID-19, including fatigue, memory and concentration problems, and dyspnea. Additionally, it was analyzed whether adding these symptoms to the EQ-5D-5L improved the explained variance for HRQoL. Patients from Uppsala University Hospital, Sweden, answered a survey that included questions on five dimensions of health represented by the EQ-5D-5L and an additional question on general health score called EQ-VAS. Multiple linear regression, Spearman’s rank correlation coefficient, and Least Absolute Shrinkage and Selection Operator (LASSO) were used to examine the sensitivity of the EQ-5D-5L. For the explanatory analysis, the Adjusted 𝑅2 was used to evaluate explanatory power with and without the presence of the symptoms. The results showed that the EQ-5D-5L dimensions explained a moderate proportion of the variance for fatigue and memory/concentration problems and a weak proportion for dyspnea. The explanatory analysis provided findings that fatigue significantly improved the explained variance of EQ-VAS by 5.5%, adding memory/concentration problems only improved it marginally, and adding dyspnea was non-significant. Additionally, strong to moderate correlations between fatigue and memory/concentration problems were found with multiple dimensions of the EQ-5D-5L. These findings suggest that the EQ-5D-5L instrument may be a valuable tool in assessing HRQoL in patients with persistent COVID-19 symptoms and that adding fatigue to the EQ-5D-5L could be beneficial for improving explanatory power to HRQoL in patients suffering from infectious disease. / COMBAT post-covid