The effects of type 1 diabetes and its long-term complications on physical and mental health status.
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.
Hahl
Jarmo
J
Department of Economics, Turku School of Economics and Business Administration, Turku, Finland. jarmo.hahl@gsk.com
Hämäläinen
Helena
H
Simell
Tuula
T
Simell
Olli
O
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