title: Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil: data from the Brazilian Type 1 Diabetes Study Group.
abstract: BACKGROUND
  In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities.
  
  
  METHODS
  This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected.
  
  
  RESULTS
  We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North-Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined.
  
  
  CONCLUSIONS
  Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities.
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: João Soares
authors.initials: JS
authors.lastname: Felício
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Ana Carolina Contente Braga
authors.initials: AC
authors.lastname: de Souza
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Camila Cavalcante
authors.initials: CC
authors.lastname: Koury
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: João Felício Abrahão
authors.initials: JF
authors.lastname: Neto
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Karem Barbosa
authors.initials: KB
authors.lastname: Miléo
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Flávia Marques
authors.initials: FM
authors.lastname: Santos
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Ana Regina Bastos
authors.initials: AR
authors.lastname: Motta
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Denisson Dias
authors.initials: DD
authors.lastname: Silva
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Thaís Pontes
authors.initials: TP
authors.lastname: Arbage
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Carolina Tavares
authors.initials: CT
authors.lastname: Carvalho
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Hana Andrade
authors.initials: HA
authors.lastname: de Rider Brito
authors.affiliation: Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará 66073-000 Brazil.
authors.forename: Elizabeth Sumi
authors.initials: ES
authors.lastname: Yamada
authors.affiliation: Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Roberta Arnoldi
authors.initials: RA
authors.lastname: Cobas
authors.affiliation: Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Matheus
authors.affiliation: Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Lucianne
authors.initials: L
authors.lastname: Tannus
authors.affiliation: Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Catia Cristina Sousa
authors.initials: CC
authors.lastname: Palma
authors.affiliation: Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Leticia
authors.initials: L
authors.lastname: Japiassu
authors.affiliation: Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: João Regis Ivar
authors.initials: JR
authors.lastname: Carneiro
authors.affiliation: Federal University Hospital of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Melanie
authors.initials: M
authors.lastname: Rodacki
authors.affiliation: Federal University Hospital of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Lenita
authors.initials: L
authors.lastname: Zajdenverg
authors.affiliation: General Hospital of Bonsucesso, Rio De Janeiro, Brazil.
authors.forename: Neuza Braga Campos
authors.initials: NB
authors.lastname: de Araújo
authors.affiliation: General Hospital of Bonsucesso, Rio De Janeiro, Brazil.
authors.forename: Marilena
authors.initials: M
authors.lastname: de Menezes Cordeiro
authors.affiliation: University Hospital Clementino Fraga Filho, Children Institute Martagão Teixeira, Rio De Janeiro, Brazil.
authors.forename: Jorge Luiz
authors.initials: JL
authors.lastname: Luescher
authors.affiliation: University Hospital Clementino Fraga Filho, Children Institute Martagão Teixeira, Rio De Janeiro, Brazil.
authors.forename: Renata Szundy
authors.initials: RS
authors.lastname: Berardo
authors.affiliation: Diabetes Unit, University Hospital of São Paulo, São Paulo, Brazil.
authors.forename: Marcia
authors.initials: M
authors.lastname: Nery
authors.affiliation: Diabetes Unit, University Hospital of São Paulo, São Paulo, Brazil.
authors.forename: Catarina
authors.initials: C
authors.lastname: Cani
authors.affiliation: Diabetes Unit, University Hospital of São Paulo, São Paulo, Brazil.
authors.forename: Maria
authors.initials: M
authors.lastname: do Carmo Arruda Marques
authors.affiliation: Pediatric Unit of Endocrinology, Santa Casa Hospital, São Paulo, Brazil.
authors.forename: Luiz Eduardo
authors.initials: LE
authors.lastname: Calliari
authors.affiliation: Pediatric Unit of Endocrinology, Santa Casa Hospital, São Paulo, Brazil.
authors.forename: Renata Maria
authors.initials: RM
authors.lastname: de Noronha
authors.affiliation: Children Institute of Endocrinology, University Hospital of São Paulo, São Paulo, Brazil.
authors.forename: Thais Della
authors.initials: TD
authors.lastname: Manna
authors.affiliation: Children Institute of Endocrinology, University Hospital of São Paulo, São Paulo, Brazil.
authors.forename: Roberta
authors.initials: R
authors.lastname: Savoldelli
authors.affiliation: Children Institute of Endocrinology, University Hospital of São Paulo, São Paulo, Brazil.
authors.forename: Fernanda Garcia
authors.initials: FG
authors.lastname: Penha
authors.affiliation: Ribeirão Preto Medical School of São Paulo University, Ribeirão Preto, Brazil.
authors.forename: Milton Cesar
authors.initials: MC
authors.lastname: Foss
authors.affiliation: Ribeirão Preto Medical School of São Paulo University, Ribeirão Preto, Brazil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Foss-Freitas
authors.affiliation: Department of Internal Medicine, Medical School, State University of São José do Rio Preto, São José Do Rio Preto, Brazil.
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Pires
authors.affiliation: Department of Internal Medicine, Medical School, State University of São José do Rio Preto, São José Do Rio Preto, Brazil.
authors.forename: Fernando Cesar
authors.initials: FC
authors.lastname: Robles
authors.affiliation: Bauru's Diabetics Association, Bauru, São Paulo Brazil.
authors.forename: Carlos Antonio
authors.initials: CA
authors.lastname: Negrato
authors.affiliation: Bauru's Diabetics Association, Bauru, São Paulo Brazil.
authors.forename: Maria
authors.initials: M
authors.lastname: de Fatima Guedes
authors.affiliation: Diabetes Unit, Federal University of São Paulo State, São Paulo, Brazil.
authors.forename: Sergio Atala
authors.initials: SA
authors.lastname: Dib
authors.affiliation: Diabetes Unit, Federal University of São Paulo State, São Paulo, Brazil.
authors.forename: Patricia
authors.initials: P
authors.lastname: Dualib
authors.affiliation: Endocrinology Unit, Hospital of Santa Casa of Belo Horizonte, Belo Horizonte, Minas Gerais Brazil.
authors.forename: Saulo Cavalcanti
authors.initials: SC
authors.lastname: da Silva
authors.affiliation: Endocrinology Unit, Hospital of Santa Casa of Belo Horizonte, Belo Horizonte, Minas Gerais Brazil.
authors.forename: Janice
authors.initials: J
authors.lastname: Sepúlveda
authors.affiliation: Diabetes Unit, State University Hospital of Londrina, Paraná, Brazil.
authors.forename: Emerson
authors.initials: E
authors.lastname: Sampaio
authors.affiliation: Clinical Hospital of the Federal University of Paraná, Paraná, Brazil.
authors.forename: Rosangela Roginski
authors.initials: RR
authors.lastname: Rea
authors.affiliation: Clinical Hospital of the Federal University of Paraná, Paraná, Brazil.
authors.forename: Ana Cristina Ravazzani
authors.initials: AC
authors.lastname: de Almeida Faria
authors.affiliation: Institute of Diabetic Children, Porto Alegre, Rio Grande do Sul Brazil.
authors.forename: Balduino
authors.initials: B
authors.lastname: Tschiedel
authors.affiliation: Institute of Diabetic Children, Porto Alegre, Rio Grande do Sul Brazil.
authors.forename: Suzana
authors.initials: S
authors.lastname: Lavigne
authors.affiliation: Institute of Diabetic Children, Porto Alegre, Rio Grande do Sul Brazil.
authors.forename: Gustavo Adolfo
authors.initials: GA
authors.lastname: Cardozo
authors.affiliation: Clinical Hospital of Porto Alegre, Porto Alegre, Rio Grande do Sul Brazil.
authors.forename: Mirela
authors.initials: M
authors.lastname: Azevedo
authors.affiliation: Clinical Hospital of Porto Alegre, Porto Alegre, Rio Grande do Sul Brazil.
authors.forename: Luis Henrique
authors.initials: LH
authors.lastname: Canani
authors.affiliation: Clinical Hospital of Porto Alegre, Porto Alegre, Rio Grande do Sul Brazil.
authors.forename: Alessandra Teixeira
authors.initials: AT
authors.lastname: Zucatti
authors.affiliation: University Hospital of Santa Catarina, Florianópolis, Santa Catarina Brazil.
authors.forename: Marisa Helena Cesar
authors.initials: MH
authors.lastname: Coral
authors.affiliation: University Hospital of Santa Catarina, Florianópolis, Santa Catarina Brazil.
authors.forename: Daniela Aline
authors.initials: DA
authors.lastname: Pereira
authors.affiliation: Endocrinology and Diabetes Institute of Joinville, Joinville, Santa Catarina Brazil.
authors.forename: Luiz Antonio
authors.initials: LA
authors.lastname: de Araujo
authors.affiliation: Regional Hospital of Taguatinga, Brasília, Brazil.
authors.forename: Hermelinda Cordeiro
authors.initials: HC
authors.lastname: Pedrosa
authors.affiliation: Regional Hospital of Taguatinga, Brasília, Brazil.
authors.forename: Monica
authors.initials: M
authors.lastname: Tolentino
authors.affiliation: Regional Hospital of Taguatinga, Brasília, Brazil.
authors.forename: Flaviene Alves
authors.initials: FA
authors.lastname: Prado
authors.affiliation: General Hospital of Goiânia, Goiânia, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: Rassi
authors.affiliation: General Hospital of Goiânia, Goiânia, Brazil.
authors.forename: Leticia Bretones
authors.initials: LB
authors.lastname: de Araujo
authors.affiliation: Diabetes and Endocrinology Center of Bahia, Salvador, Bahia Brazil.
authors.forename: Reine Marie Chaves
authors.initials: RM
authors.lastname: Fonseca
authors.affiliation: Diabetes and Endocrinology Center of Bahia, Salvador, Bahia Brazil.
authors.forename: Alexis Dourado
authors.initials: AD
authors.lastname: Guedes
authors.affiliation: Diabetes and Endocrinology Center of Bahia, Salvador, Bahia Brazil.
authors.forename: Odelisa Silva
authors.initials: OS
authors.lastname: de Mattos
authors.affiliation: Federal University of Maranhão, São Luís, Maranhão Brazil.
authors.forename: Manuel
authors.initials: M
authors.lastname: Faria
authors.affiliation: Federal University of Maranhão, São Luís, Maranhão Brazil.
authors.forename: Rossana
authors.initials: R
authors.lastname: Azulay
authors.affiliation: Diabetes and Hypertension Center of Ceará, Fortaleza, Ceará Brazil.
authors.forename: Adriana Costa
authors.initials: AC
authors.lastname: E Forti
authors.affiliation: Diabetes and Hypertension Center of Ceará, Fortaleza, Ceará Brazil.
authors.forename: Cristina Figueiredo Sampaio
authors.initials: CF
authors.lastname: Façanha
authors.affiliation: Federal University of Ceará, Fortaleza, Ceará Brazil.
authors.forename: Renan Montenegro
authors.initials: RM
authors.lastname: Junior
authors.affiliation: Federal University of Ceará, Fortaleza, Ceará Brazil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Montenegro
authors.affiliation: Federal University of Sergipe, São Cristóvão, Sergipe Brazil.
authors.forename: Naira Horta
authors.initials: NH
authors.lastname: Melo
authors.affiliation: Federal University of Sergipe, São Cristóvão, Sergipe Brazil.
authors.forename: Karla Freire
authors.initials: KF
authors.lastname: Rezende
authors.affiliation: Federal University Hospital of Campina Grande, Campina Grande, Paraíba Brazil.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ramos
authors.affiliation: Getúlio Vargas University Hospital of Amazonas, Adriano Jorge Hospital, Manaus, Amazonas Brazil.
authors.forename: Deborah Laredo
authors.initials: DL
authors.lastname: Jezini
authors.affiliation: Diabetes Unit, Department of Internal Medicine, State University of Rio de Janeiro, Rio De Janeiro, Brazil.
authors.forename: Marilia Brito
authors.initials: MB
authors.lastname: Gomes
keywords: EuroQol; Health-related quality of life; Type 1 diabetes mellitus