title: The influence of cardiovascular disease on quality of life in type 2 diabetics.
abstract: OBJECTIVE
  In type 2 diabetes mellitus, disease-related complications have a considerable effect on the quality of life. We studied the influence of cardiovascular disease on quality of life in type 2 diabetic patients in a longitudinal design. We also studied whether quality of life in any way predicts the manifestation of cardiovascular disease.
  
  
  METHODS
  A prospective cohort study from April 1996 to October 1999. In 1996 and 1999 all known type 2 diabetics from the population of Urk, the Netherlands, were invited by their general practitioners (GPs) for extensive check-up. In both years quality of life was assessed using the generic RAND-36 and the disease-specific Diabetes Health Profile (DHP). In the intermediate period, cardiovascular morbidity and mortality were registered by the GPs.
  
  
  RESULTS
  In 1996, 281 patients were examined and 248 (88.3%) persons completed the questionnaires. After 3 years 189 persons (67.3%) were re-examined and 161 (85.2%) handed in the questionnaire. When compared to diabetics without cardiovascular disease, diabetics with cardiovascular disease had a lower quality of life. Multiple regression analysis showed that contracting cardiovascular disease negatively affects the RAND-36 dimensions 'social functioning', 'vitality' and 'health change'. Cox's regression analysis showed a negative relation between the RAND-36 dimensions 'physical functioning', and time to the manifestation of cardiovascular disease. The DHP appeared not to be suitable to measure quality of life in relation to cardiovascular disease.
  
  
  CONCLUSIONS
  In type 2 diabetics, cardiovascular disease has a negative effect on quality of life. A decreased quality of life is associated with a short-term manifestation of cardiovascular disease.
authors.affiliation: Department of General Practice, University of Groningen, The Netherlands. cdvisser@ision.nl
authors.forename: C L
authors.initials: CL
authors.lastname: de Visser
authors.forename: H J G
authors.initials: HJ
authors.lastname: Bilo
authors.forename: K H
authors.initials: KH
authors.lastname: Groenier
authors.forename: W
authors.initials: W
authors.lastname: de Visser
authors.forename: B
authors.initials: B
authors.lastname: Jong Meyboom-de
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000401:mortality; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors