title: Health-related quality of life in women and men with type 2 diabetes: a comparison across treatment groups.
abstract: OBJECTIVE
  This study compares health-related quality of life (HRQL) in patients with type 2 diabetes (T2DM) across treatment groups and explores gender differences.
  
  
  METHODS
  Four regional surveys (KORA, CARLA, SHIP, DHS) and a national survey (GNHIES98) were pooled at individual level. HRQL was assessed with the SF-12/-36v1. Linear regression models were used to assess the effect of T2DM by treatment type (no medication; oral; oral/insulin combination; insulin) on the physical (PCS-12) and mental summary score (MCS-12) and the SF-6D, controlling for age, sex, study and covariates. We also performed an explanatory analysis of single items.
  
  
  RESULTS
  PCS-12 scores and treatment type were associated (P-value 0.006), with lowest values for insulin treatment (-4.44 vs. oral; -4.41 vs. combination). MCS-12 scores were associated with treatment type and gender (P-value <0.012), with lower scores for women undergoing oral (-4.25 vs. men) and combination treatment (-6.99 vs. men). Similar results were observed for SF-6D utilities and single items, related to mental health, social functioning, vitality and role limitation (emotional). Comorbidities were predictors of lower PCS-12 and SF-6D scores.
  
  
  CONCLUSIONS
  T2DM treatment impacts differently on physical and mental HRQL and on women and men. Further studies of gender-specific perceptions of T2DM treatment regimens are needed.
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schunk
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Reitmeir
authors.affiliation: Institute for Community Medicine, Ernst Moritz Arndt-University, Greifswald, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schipf
authors.affiliation: Institute for Community Medicine, Ernst Moritz Arndt-University, Greifswald, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Völzke
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Meisinger
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: K-H
authors.initials: KH
authors.lastname: Ladwig
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kluttig
authors.affiliation: Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany; German Cancer Research Centre, Division of Cancer Epidemiology, Heidelberg, Germany.
authors.forename: K H
authors.initials: KH
authors.lastname: Greiser
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Berger
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Müller
authors.affiliation: Department of Epidemiology and Health Reporting, Robert-Koch-Institute, Berlin, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Ellert
authors.affiliation: Department of Epidemiology and Health Reporting, Robert-Koch-Institute, Berlin, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Neuhauser
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Tamayo
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Rathmann
authors.affiliation: Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Holle
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy / Q000009:adverse effects; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D003927:Diet, Diabetic / Q000009:adverse effects; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012727:Sex Characteristics; D013312:Stress, Physiological / Q000187:drug effects; D013315:Stress, Psychological / Q000453:epidemiology*
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Gender; HRQL; SF-12; T2DM; Treatment