title: Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study.
abstract: OBJECTIVE
  The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration.
  
  
  METHODS
  3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared.
  
  
  RESULTS
  PCS and SF-6D scores declined in all participants in all treatment arms (P < .001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P < .001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P < .001) and two years (P < .001) post-diagnosis.
  
  
  CONCLUSIONS
  Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes.
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA, dppmail@bsc.gwu.edu.
authors.forename: D
authors.initials: D
authors.lastname: Marrero
authors.forename: Q
authors.initials: Q
authors.lastname: Pan
authors.forename: E
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: M
authors.initials: M
authors.lastname: de Groot
authors.forename: P
authors.initials: P
authors.lastname: Zhang
authors.forename: C
authors.initials: C
authors.lastname: Percy
authors.forename: H
authors.initials: H
authors.lastname: Florez
authors.forename: R
authors.initials: R
authors.lastname: Ackermann
authors.forename: M
authors.initials: M
authors.lastname: Montez
authors.forename: R R
authors.initials: RR
authors.lastname: Rubin
mesh_terms: D015992:Body Mass Index; D001835:Body Weight / Q000208:ethnology / Q000502:physiology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010919:Placebos; D015397:Program Evaluation; D011788:Quality of Life / Q000523:psychology*; D040242:Risk Reduction Behavior; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D010919:Placebos; D008687:Metformin