title: Health-related quality of life in patients with type 1 diabetes--association with diabetic complications (the FinnDiane Study).
abstract: BACKGROUND
  The daily treatment of type 1 diabetes with frequent monitoring of blood glucose levels and nuisance caused by insulin administration may affect patients' health-related quality of life (HRQoL). Type 1 diabetes is further burdened with an increased risk of complications which may additionally reduce a patient's HRQoL. We aimed to assess HRQoL and its association with diabetic complications in a large sample of patients with type 1 diabetes.
  
  
  METHODS
  Altogether, 1070 patients with type 1 diabetes (46% men, mean age 46 +/- 12 years, diabetes duration 29 +/- 13 years) from the Finnish Diabetic Nephropathy Study (FinnDiane Study) participated in this cross-sectional study. Data on HRQoL were obtained from 1023 patients using the 15D instrument. When studying nephropathy, patients were divided into groups based on their albumin excretion rate. Laser-treated patients were classified as having proliferative retinopathy.
  
  
  RESULTS
  The mean 15D score was 0.899 +/- 0.095 with no differences between men and women. HRQoL decreased with increasing age among patients with and without diabetic complications. In the Tobit regression model, macroalbuminuria (-0.036), dialysis (-0.082), renal transplant (-0.053), poor glycemic control (-0.006), ageing (-0.002) and longer diabetes duration (-0.001) explained the reduction in HRQoL. In a corresponding model, the presence of proliferative retinopathy did not have a significant negative influence on HRQoL. Of individual dimensions of the 15D instrument, nephropathy affected all but five dimensions, while retinopathy affected vision, mobility, eating and usual activities.
  
  
  CONCLUSIONS
  The 15D scores decreased with increasing age. The presence of nephropathy, but not retinopathy, reduced the subjective HRQoL in patients with type 1 diabetes.
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland.
authors.forename: Aila J
authors.initials: AJ
authors.lastname: Ahola
authors.forename: Markku
authors.initials: M
authors.lastname: Saraheimo
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.forename: Kustaa
authors.initials: K
authors.lastname: Hietala
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000503:physiopathology* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000523:psychology; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000523:psychology; D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires