Correlates of health-related quality of life in type 2 diabetes

Abstract

Aims/hypothesis: We assessed the impact of medical comorbidities, depression, and treatment intensity on quality of life in a large primary care cohort of patients with type 2 diabetes. Methods: We used the Health Utilities Index-III, an instrument that measures healthrelated quality of life based on community preferences in units of health utility (scaled from 0=death to 1.0=perfect health), in 909 primary care patients with type 2 diabetes. Demographic and clinical correlates of health-related quality of life were assessed. Results: The median health utility score for this population was 0.70 (interquartile range 0.39-0.88). In univariate analyses, older age, female sex, low socioeconomic status, cardiovascular disease, microvascular complications, congestive heart failure, peripheral vascular disease, chronic lung disease, depression, insulin use and number of medications correlated with decreased quality of life, while obesity, hypertension and hypercholesterolaemia did not. In multiple regression analyses, microvascular complications, heart failure and depression were most strongly related to decreased healthrelated quality of life, independently of duration of diabetes; in these models, diabetes patients with depression had a utility of 0.59, while patients without symptomatic comorbidities did not have a significantly reduced quality of life. Treatment intensity remained a significant negative correlate of quality of life in multivariable models. Conclusions/interpretation: Patients with type 2 diabetes have a substantially decreased quality of life in association with symptomatic complications. The data suggest that treatment of depression and prevention of complications have the greatest potential to improve health-related quality of life in type 2 diabetes.

Stigmata of complications on the quality of life of type 2 diabetic patients

“…The probable explanation of this correlation may be due to increasing number of complication of diabetes as age advances. Similar results were also observed by Bosseri et al (2005) and Wexler et al (2006). 7,8 In the present study we observed a more negative impact on QOL in female (-5.02) as compared to male (-4.46).…”

“…Similar results were also observed by Bosseri et al (2005) and Wexler et al (2006). 7,8 In the present study we observed a more negative impact on QOL in female (-5.02) as compared to male (-4.46). Similar observations have been reported by other workers like Redekop et al (2002) and Coffey et al (2002).…”

Obesity and vascular dysfunction

“…In humans, this can lead to loss of mobility, chronic pain, and development of psychological depression [47]. Chronically, these complications can manifest with venous stasis leading to lower limb ulcerations, increases in venous thromboembolism, and a higher rate of pulmonary embolism [48,49].…”

Assessment of Health-Related Quality of Life using the EQ-5D-3L in Individuals with Type 2 Diabetes Mellitus

“…HRQoL is a multidimensional concept that assesses the individuals' perception of their health, thus being a useful indicator for the burden of disease [16]. Diabetic patients perceive themselves as having less HRQoL than non-diabetics, and the quality of life decreases with the progression of the disease and its complications [13,17,18]. In short, the impact of its treatment, complications and comorbidities substantially affect HRQoL [17].…”