title: Diabetes-specific quality of life but not health status is independently associated with glycaemic control among patients with type 2 diabetes: a cross-sectional analysis of the ADDITION-Europe trial cohort.
abstract: OBJECTIVE
  To examine the association between health status, diabetes-specific quality of life (QoL) and glycaemic control among individuals with type 2 diabetes.
  
  
  METHODS
  1876 individuals with screen-detected diabetes and a mean age of 66 years underwent assessment of self-reported health status (SF-36), diabetes-specific QoL (the Audit of Diabetes Dependent Quality of Life (ADDQoL19)) and glycated haemoglobin (HbA1c) at five years post-diagnosis in the ADDITION-Europe trial. Multivariable linear regression was used to quantify the cross-sectional association between health status, diabetes-specific QoL and HbA1c, adjusting for age, sex, education, alcohol consumption, physical activity, BMI, intake of any glucose-lowering drugs, and trial arm.
  
  
  RESULTS
  The mean (SD) SF-36 physical and mental health summary scores were 46.2 (10.4) and 54.6 (8.6), respectively. The median average weighted impact ADDQoL score was -0.32 (IQR -0.89 to -0.06), indicating an overall negative impact of diabetes on QoL. Individuals who reported a negative impact of diabetes on their QoL had higher HbA1c levels at five years after diagnosis compared with those who reported a positive or no impact of diabetes (b-coefficient [95% CI]: b=0.2 [0.1, 0.3]). Physical and mental health summary SF-36 scores were not significantly associated with HbA1c in multivariable analysis.
  
  
  CONCLUSIONS
  Diabetes-specific QoL but not health status was independently associated with HbA1c. Practitioners should take account of the complex relationship between diabetes-specific QoL and glucose, particularly with regard to dietary behaviour. Future research should attempt to elucidate via which pathways this association might act.
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Laura
authors.initials: L
authors.lastname: Kuznetsov
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Griffin
authors.affiliation: Diabetes Research Unit, Leicester Diabetes Centre, University of Leicester, Leicester, United Kingdom.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: Department of Public Health, Section of General Practice, University of Aarhus, Aarhus, Denmark.
authors.forename: Torsten
authors.initials: T
authors.lastname: Lauritzen
authors.affiliation: Diabetes Research Unit, Leicester Diabetes Centre, University of Leicester, Leicester, United Kingdom.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.affiliation: Julius Center, Department of General Practice, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Guy E H M
authors.initials: GE
authors.lastname: Rutten
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom. Electronic address: rebecca.simmons@mrc-epid.cam.ac.uk.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D005060:Europe; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D057566:Self Report; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: ADDQoL; Diabetes-specific quality of life; HbA1c; Health status; SF-36; Type 2 diabetes