title: Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey.
abstract: OBJECTIVE
  To assess the impact of comorbid heart disease, stroke and arthritis on health-related quality of life (HRQL) in people with diabetes in the general Canadian population.
  
  
  METHODS
  Data were collected as part of the 1996-1997 Canadian National Population Health Survey. HRQL was assessed using overall Health Utilities Index Mark 3 (HUI3) and single attribute utility scores. Respondents (N = 66,093) were classified into 1 of 16 groups based on the presence or absence of diabetes, heart disease, stroke, and arthritis, in all possible combinations and HRQL scores were compared using analysis of covariance.
  
  
  RESULTS
  Overall HUI3 scores for respondents with diabetes alone (0.88, 95% CI: 0.87-0.89) were lower than controls (0.92: 95% CI: 0.92-0.92, p < 0.001). Overall HUI3 scores for diabetes in combination with heart disease (0.77, 95% CI: 0.74-0.79), arthritis (0.78, 95% CI: 0.77-0.79) or stroke (0.79, 95% CI: 0.74-0.85) were considerably lower than diabetes alone. Triplets of comorbidities were associated with overall HRQL deficits of approximately 0.26-0.30, relative to controls.
  
  
  CONCLUSIONS
  The illness burden experienced by individuals with diabetes is not only associated with diabetes itself, but largely with comorbid medical conditions.
authors.affiliation: Department of Public Health Sciences, University of Alberta, Edmonton, Canada.
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Maddigan
authors.forename: David H
authors.initials: DH
authors.lastname: Feeny
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000150:complications* / Q000523:psychology; D002170:Canada; D002908:Chronic Disease; D015897:Comorbidity; D048909:Diabetes Complications / Q000503:physiopathology* / Q000523:psychology; D003920:Diabetes Mellitus / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D020521:Stroke / Q000150:complications* / Q000523:psychology