title: Longitudinal changes in health-related quality of life in normal glucose tolerance, prediabetes and type 2 diabetes: results from the KORA S4/F4 cohort study.
abstract: OBJECTIVE
  The aim of this study was to examine how transition between normal glucose tolerance, prediabetes and diabetes over a 7 year period is associated with change in health-related quality of life (HRQL) in an elder German population-based cohort.
  
  
  METHODS
  We used data from 1,046 participants of the KORA S4/F4 cohort study aged 55-74 years at baseline. Based on an oral glucose tolerance test, prediabetes was defined as impaired fasting glucose and/or impaired glucose tolerance. HRQL was assessed with the SF-12 questionnaire. Using linear regression, we estimated mean change in HRQL over time, depending on glucose status at baseline and follow-up, adjusted by demographic and lifestyle variables.
  
  
  RESULTS
  Individuals progressing to prediabetes or diabetes experienced a greater loss in the physical component score than patients with persistent normal glucose tolerance (-2.31 and -7.44 vs. -1.08), but the difference was only significant for subjects converting to diabetes. Subjects with prediabetes at baseline and diabetes at follow-up had a significant loss in mental health compared to subjects with persistent prediabetes.
  
  
  CONCLUSIONS
  There is first evidence that worsening of glucose metabolism over time is associated with deteriorating HRQL, however, further and larger longitudinal studies are needed to confirm these findings.
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, 85764, Neuherberg, Germany, matthias.hunger@helmholtz-muenchen.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hunger
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Michaela
authors.initials: M
authors.lastname: Schunk
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D005947:Glucose; D018149:Glucose Intolerance; D006304:Health Status; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011236:Prediabetic State / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D005947:Glucose
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