title: Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy.
abstract: OBJECTIVE
  To investigate a 10-year change of quality of life and associated factors in a population with type 1 diabetes.
  
  
  METHODS
  The Medical Outcome Study Short Form-36 (SF-36) was administered in participants (n = 520) at the 1995-1996 and 2005-2007 examination phases of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Physical (PCS) and mental (MCS) component summary scores were calculated. The associations between changes of quality of life and demographic, socioeconomic, and clinical factors were analyzed.
  
  
  RESULTS
  PCS score decreased (p < 0.001) and MCS score increased (p < 0.001) after 10 years. The development of cardiovascular disease and the presence of limb amputation were associated with decrease in the PCS score. Those who were working and retired had increased MCS; those who were working and stopped had a decrease in the MCS score. Change in visual acuity and diabetic retinopathy status did not have a significant impact in health-related quality of life scores.
  
  
  CONCLUSIONS
  Our findings reinforce the necessity to make every attempt to decrease complications of diabetes in individuals with long-term type 1 diabetes in order to attenuate the diminished quality of life associated with those complications such as cardiovascular disease. Change in employment status, likely due to development of these complications, was also strongly associated with poorer quality of life and suggests the benefits of preventing or decreasing complications to keep people with type 1 diabetes in the workforce.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. fhirai@yahoo.com
authors.forename: Flavio E
authors.initials: FE
authors.lastname: Hirai
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D003930:Diabetic Retinopathy / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014922:Wisconsin / Q000453:epidemiology