title: The effects of type 1 diabetes and its long-term complications on physical and mental health status.
abstract: OBJECTIVE
  To analyse how type 1 diabetes mellitus (DM) and the symptoms of its chronic long-term complications correlate with health status domains in the adult population in Finland.
  
  
  METHODS
  A representative sample of patients with type 1 DM was selected randomly from the Finnish drug reimbursement registry. Participants reported symptoms, diagnoses and treatments indicating the presence and time of appearance of long-term complications, and completed the RAND 36 questionnaire. A principal component analysis was performed to compress the eight RAND 36 dimensions into composite domains of health status. The results were validated with split-sample analysis. Regression analyses were used to estimate the effects of age, sex, symptoms of long-term complications and comorbidities on the component T-scores.
  
  
  RESULTS
  Of the 752 (70.8%) responders, 592 fulfilled the criteria of type 1 DM. Of these, 82.6% fully completed the RAND 36 questionnaire. Principal component analysis of our data supports the theory of the 2-factor model of health, as physical and mental health domains were reflected unambiguously by different RAND 36 dimensions. The regression results show that the symptoms of long-term complications correlate more strongly with the physical than the mental domain of health status.
  
  
  CONCLUSIONS
  Type 1 DM, and especially the symptoms of its long-term complications, correlate mainly with the physical domain of health, although the mental domain is also affected. The prevalence of long-term complications with type 1 DM is sufficiently high within the Finnish population to substantially influence the health status of people with type 1 DM.
authors.affiliation: Department of Economics, Turku School of Economics and Business Administration, Turku, Finland. jarmo.hahl@gsk.com
authors.forename: Jarmo
authors.initials: J
authors.lastname: Hahl
authors.forename: Helena
authors.initials: H
authors.lastname: Hämäläinen
authors.forename: Tuula
authors.initials: T
authors.lastname: Simell
authors.forename: Olli
authors.initials: O
authors.lastname: Simell
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D048909:Diabetes Complications / Q000191:economics / Q000503:physiopathology* / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000191:economics / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005387:Finland; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012042:Registries; D011795:Surveys and Questionnaires