title: Fifteen-year follow-up of quality of life in type 1 diabetes mellitus.
abstract: OBJECTIVE
  To evaluate metabolic control and health-related quality of life (HRQOL) in a type 1 diabetes mellitus (T1DM) population.
  
  
  METHODS
  As part of a prospective cohort study, 283 T1DM patients treated with various insulin treatment modalities including multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII) were examined annually. HRQOL was measured using the SF-36 and EuroQol questionnaires. Data regarding HRQOL, glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed. Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.
  
  
  RESULTS
  Significant changes [mean Δ (95%CI)] in body mass index [2.4 kg/m(2) (1.0, 3.8)], systolic blood pressure [-6.4 mmHg (-11.4, -1.3)] and EuroQol-VAS [-7.3 (-11.4, -3.3)] were observed over time. In 2010, 168 patients were lost to follow-up. Regarding mode of therapy, 52 patients remained on MDI, 28 remained on CSII, and 33 patients switched from MDI to CSII during follow-up. Among patients on MDI, HRQOL decreased significantly over time: mental component summary [-9.8 (-16.3, -3.2)], physical component summary [-8.6 (-15.3, -1.8)] and EuroQol-VAS [-8.1 (-14.0, -2.3)], P < 0.05 for all. For patients using CSII, the EuroQol-VAS decreased [-9.6 (-17.5, -1.7)]. None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.
  
  
  CONCLUSIONS
  No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.
authors.affiliation: Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands.
authors.forename: Peter R
authors.initials: PR
authors.lastname: van Dijk
authors.affiliation: Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands.
authors.forename: Susan Jj
authors.initials: SJ
authors.lastname: Logtenberg
authors.affiliation: Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands.
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.affiliation: Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands.
authors.forename: Joost C
authors.initials: JC
authors.lastname: Keers
authors.affiliation: Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands.
authors.forename: Henk Jg
authors.initials: HJ
authors.lastname: Bilo
authors.affiliation: Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands.
authors.forename: Nanne
authors.initials: N
authors.lastname: Kleefstra
keywords: Continuous subcutaneous insulin infusion; Glycaemic control; Health-related quality of life; Insulin treatment; Multiple daily injections; Type 1 diabetes mellitus