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

• Published in: Diabetes research and clinical practice 2014-05, Vol.104 (2), p.281-287
• Main Authors: Kuznetsov, Laura, Griffin, Simon J, Davies, Melanie J, Lauritzen, Torsten, Khunti, Kamlesh, Rutten, Guy E.H.M, Simmons, Rebecca K
• Format: Article
• Language: English
• Subjects: ADDQoL; Adult; Aged; Blood Glucose - metabolism; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - psychology; Diabetes-specific quality of life; Endocrinology & Metabolism; Europe; Female; Glycated Hemoglobin A - metabolism; HbA1c; Health Status; Humans; Hypoglycemic Agents - therapeutic use; Male; Mental Health; Middle Aged; Prognosis; Quality of Life; Self Report; SF-36; Surveys and Questionnaires; Type 2 diabetes
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2013.12.029

Abstract Aims 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.