title: The health-related utility and health-related quality of life of hospital-treated subjects with type 1 or type 2 diabetes with particular reference to differing severity of peripheral neuropathy.
abstract: OBJECTIVE
  We characterised symptom severity of diabetic peripheral neuropathy (DPN) in people with diabetes, and correlated this with health-related utility and health-related quality of life.
  
  
  METHODS
  The study was undertaken in Cardiff and the Vale of Glamorgan, Wales. A postal survey was mailed to a random sample of subjects identified as having diabetes. Data were collected on the symptoms of neuropathy using the Neuropathic Total Symptom Score (self-administered) (NTSS-6-6A) and on quality of life using the Quality of Life in Diabetes Neuropathy Instrument (QoL-DN), EueroQoL five dimensions (EQ5D) and Short Form 36 (SF36). Other information, such as demographics and self-reported drug use, was also collected. The anonymised data were linked to routine inpatient and outpatient healthcare data.
  
  
  RESULTS
  Responses were received from 1,298 patients. For patients with a clinically confirmed diagnosis of DPN, the mean NTSS-6-SA score was 6.16 vs 3.19 in patients without DPN (p<0.001). Four categories of severity were defined, ranging from none to severe. All quality of life measures showed a deterioration between these groups: the EQ5D(index) fell from an average of 0.81 in those without symptoms to 0.25 in those with severe symptoms, the SF36 general health profile fell from 59.9 to 25.5 (p<0.001) and the QoL-DN increased from 25.8 to 48.1 (p<0.001). Multivariate models also demonstrated that this relationship remained after controlling for other factors.
  
  
  CONCLUSIONS
  This study demonstrated that severity of DPN symptoms was predictive of poor health-related utility and decreased quality of life. Furthermore, it provides detailed utility data for economic evaluation of treatment of typical diabetes-related morbidity states. Reducing DPN morbidity should be a priority.
authors.affiliation: Department of Medicine, School of Medicine, Cardiff University, Cardiff, UK. currie@cardiff.ac.uk
authors.forename: C J
authors.initials: CJ
authors.lastname: Currie
authors.forename: C D
authors.initials: CD
authors.lastname: Poole
authors.forename: A
authors.initials: A
authors.lastname: Woehl
authors.forename: C Ll
authors.initials: CL
authors.lastname: Morgan
authors.forename: S
authors.initials: S
authors.lastname: Cawley
authors.forename: M D
authors.initials: MD
authors.lastname: Rousculp
authors.forename: M T
authors.initials: MT
authors.lastname: Covington
authors.forename: J R
authors.initials: JR
authors.lastname: Peters
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000523:psychology; D003929:Diabetic Neuropathies / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires