Impact of long-term complications on quality of life in patients with type 2 diabetes not using insulin.
OBJECTIVE
The complications of diabetes have the potential to greatly impact the health-related quality of life (HRQOL) of patients with type 2 diabetes. The effect of diabetic complications on HRQOL was assessed in 1233 patients with type 2 diabetes who were not using insulin.


METHODS
Patients were aged 35 and older and had stable fasting serum glucose (FSG) after washout of antidiabetic therapy. Patients who required insulin or suffered from severe cardiovascular or hepatic disease, neuropathy, or retinopathy were excluded. Patients completed the SF-36 generic quality of life questionnaire. Demographic data, including body mass index (BMI), blood glucose hemoglobin A1c (HbA1c), FSG, and the presence and severity of eight specified diabetic complications were also collected. A linear regression analysis was performed for each of the SF-36 domains and for the physical and mental health summary scales.


RESULTS
The most prevalent diabetic complications were hypertension (46% of patients), peripheral sensory neuropathy (PSN; 12%), coronary artery disease (CAD; 8%), retinopathy (8%), and peripheral vascular disease (PVD; 7%). Most (73%) of the complications were assessed to be mild. PSN was associated with significantly lower scores (i.e., worse quality of life) in the mental health scale; CAD was associated with significant reductions of all but role-emotional and mental health scales of the SF-36; and PVD was associated with significantly lower physical and social functioning scales. Hypertension did not have an independent effect on HRQOL.


CONCLUSIONS
The presence of even mild diabetic complications has a significant impact on patients' quality of life. Early diagnosis and treatment is essential to help prevent deterioration of HRQOL in these patients.
Lloyd
A
A
Fourth Hurdle Consulting Ltd., 2 Fisher Street, Holborn London WC1R 4QA, UK. Adamlloyd@FourthHurdle.com
Sawyer
W
W
Hopkinson
P
P
D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000209:etiology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000523:psychology; D003928:Diabetic Nephropathies / Q000209:etiology / Q000523:psychology; D003929:Diabetic Neuropathies / Q000209:etiology / Q000523:psychology; D006305:Health Status Indicators; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000523:psychology; D016014:Linear Models; D008134:Long-Term Care; D008875:Middle Aged; D010465:Perception; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires