title: Quality of life along the diabetes continuum: a cross-sectional view of health-related quality of life and general health status in middle-aged and older Finns.
abstract: OBJECTIVE
  To examine the general health status and health-related quality of life (HRQOL) along the diabetes continuum of middle-aged and older Finns, and to determine the glucose metabolism stage by which the HRQOL has decreased noticeably.
  
  
  METHODS
  The cross-sectional sample consisted of 920 persons aged 51-75 from the general population in a single municipality in a rural area of Eastern Finland. Data were adjusted for age, sex, smoking history, current alcohol consumption, employment and marital status. The HRQOL and health status were evaluated using two preference-based HRQOL instruments, 15D and SF-6D, and one health profile instrument, 36-Item Short Form Health Survey (SF-36).
  
  
  RESULTS
  Individuals with impaired glucose tolerance (IGT) and type 2 diabetes had noticeably low mean SF-6D, 15D and general health status. The decrease in overall HRQOL was mainly due to a decline in the physical dimensions of HRQOL. The adjusted odds ratios (95% CI) for having noticeably low HRQOL on SF-6D, 15D and general health dimension of SF-36 associated with IGT were 1.95 (1.18-3.25), 1.35 (0.84-2.18) and 2.00 (1.21-3.29), respectively.
  
  
  CONCLUSIONS
  The progression along the diabetes continuum was significantly associated with a decrease in HRQOL and health status. Furthermore, the data indicate that when a person is detected to have IGT, the HRQOL and general health status have already diminished noticeably. The prevailing evidence suggests that detection and intervention before a patient develops IGT is essential in order to minimize the loss of quality of life and quality-adjusted life years.
authors: Pharmacoeconomics and Outcomes Research Unit, Faculty of Health Sciences, School of Pharmacy, Social Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland, saku.vaatainen@uef.fi.
authors: Saku
authors: S
authors: Väätäinen
authors: Sirkka
authors: S
authors: Keinänen-Kiukaanniemi
authors: Jouko
authors: J
authors: Saramies
authors: Hannu
authors: H
authors: Uusitalo
authors: Jaakko
authors: J
authors: Tuomilehto
authors: Janne
authors: J
authors: Martikainen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D005387:Finland; D018149:Glucose Intolerance / Q000097:blood / Q000523:psychology; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D015415:Biomarkers; D001786:Blood Glucose