title: Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life.
abstract: OBJECTIVE
  Morbidity from GI symptoms in diabetes is considered to be high, but no studies have quantified the impact of GI symptoms in diabetes on health-related quality of life. We hypothesized that diabetics reporting increased GI symptoms would experience more impaired quality of life.
  
  
  METHODS
  Subjects from the community with diabetes (n = 892) and outpatients with diabetes (n = 209) were recruited for this study. Subjects were divided into type 1 (diabetes diagnosed at age <30 yr and requiring insulin) and type 2. A validated questionnaire measuring GI symptoms and diabetes status and the Short Form-36 were completed. The results were compared with Australian normal data. GI symptom groups measured were frequent abdominal pain, bowel-related abdominal pain, reflux, dyspepsia, constipation, diarrhea, and fecal incontinence.
  
  
  RESULTS
  There was a clinically significant decrease in quality-of-life scores in diabetics compared with population norms across all subscales. The impact on quality of life in diabetes was predominantly observed in type 2 diabetics. The quality-of-life scores in all subscales decreased markedly with increasing numbers of distinct GI symptom groups, and this was similar in community and outpatient diabetics. For all the Short Form-36 subscales, GI symptom groups were significantly (all p < 0.0001) associated with poorer quality of life in diabetes, independent of age, gender, smoking, alcohol use, and type of diabetes.
  
  
  CONCLUSIONS
  GI symptoms impact negatively on health-related quality of life in diabetes mellitus.
authors.affiliation: Department of Medicine, University of Sydney, Nepean Hospital, Kingswood, New South Wales, Australia.
authors.forename: N J
authors.initials: NJ
authors.lastname: Talley
authors.forename: L
authors.initials: L
authors.lastname: Young
authors.forename: P
authors.initials: P
authors.lastname: Bytzer
authors.forename: J
authors.initials: J
authors.lastname: Hammer
authors.forename: M
authors.initials: M
authors.lastname: Leemon
authors.forename: M
authors.initials: M
authors.lastname: Jones
authors.forename: M
authors.initials: M
authors.lastname: Horowitz
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011336:Probability; D011788:Quality of Life; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires