Impact of comorbid diabetes on quality of life and perception of angina pain in people with angina registered with general practitioners in the UK.
OBJECTIVE
To investigate the impact of comorbid diabetes on general and angina-related quality of life (QoL) in people with angina.


METHODS
We analysed data for a subset of patients with angina, from a randomised controlled trial conducted in UK primary care. SF36 scores and Seattle Angina Questionnaire scores were compared for people with and without diabetes. We adopted a robust statistical approach, using nonparametric quantile regression to adjust for the influence of potential confounders.


RESULTS
Data were available for 904 cases of whom 181 (20%) had diabetes. Presence of comorbid diabetes was significantly associated with reduced generic QoL for all SF36 domains and Seattle Angina Questionnaire physical limitation scores (estimated regression coefficient -12.33), but not for the other angina-related scores. Greater frequency of perceived angina was strongly correlated with reduced QoL (P<0.001) and angina frequency was similar in people with and without diabetes (P=0.576).


CONCLUSIONS
Our results confirm the cumulative impact of having multiple chronic diseases on QoL. Though limited by the data available, our finding of similar angina frequency in patients with and without diabetes contributes to the debate regarding the influence of autonomic neuropathy on perception of angina in people with diabetes.
Department of Health Sciences, University of Leicester, 22-28 Princess Road West, Leicester LE1 6TP, UK. mas20@le.ac.uk
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Stone
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Khunti
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Squire
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Paul
D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D010465:Perception; D010821:Physicians, Family / Q000523:psychology / Q000706:statistics & numerical data*; D011581:Psychological Tests; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D006113:United Kingdom