Health-related quality of life in patients with type 2 diabetes initiating a second-line glucose-lowering therapy: The DISCOVER study

• Published in: Diabetes research and clinical practice 2021-10, Vol.180, p.108974-108974, Article 108974
• Main Authors: Nicolucci, Antonio, Chen, Hungta, Cid-Ruzafa, Javier, Cooper, Andrew, Fenici, Peter, Gomes, Marilia B, Hammar, Niklas, Khunti, Kamlesh, Kosiborod, Mikhail, Leigh, Paul, Medin, Jennie, Rathmann, Wolfgang, Shestakova, Marina V., Shimomura, Iichiro, Siddiqui, Afrah, Tang, Fengming, Watada, Hirotaka, Ji, Linong
• Format: Article
• Language: English
• Subjects: HRQoL; Type 2 diabetes mellitus
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2021.108974

•Patients with type 2 diabetes have lower quality of life than the general population.•Patients with type 2 diabetes had similar quality of life across geographic regions.•Patients reported lower mental health than physical health.•Patient-, disease- and treatment-related factors correlated with quality of life.•Increased fear of hypoglycaemia was associated with lower quality of life. To investigate factors associated with health-related quality of life (HRQoL) in patients with type 2 diabetes mellitus (T2D) at initiation of second-line glucose-lowering therapy. DISCOVER is a 3-year, prospective observational study of patients with T2D initiating second-line glucose-lowering therapy, conducted in 38 countries. HRQoL at baseline was assessed using the physical and mental component summary (PCS; MCS) scores of the 36-Item Short Form Health Survey version 2 (SF-36v2) in 31 countries (n = 8309) and the Hypoglycaemia Fear Survey-II (HFS-II) in 23 countries (n = 6516). Factors associated with differences in HRQoL were assessed using multivariable hierarchical regression models. Mean PCS and MCS scores were 48.0 (standard deviation [SD]: 7.8) and 45.5 (SD: 10.4), respectively. Factors associated with significantly lower SF-36v2 scores included being female, having a history of macrovascular complications and first-line treatment with oral combinations (vs metformin monotherapy). Mean HFS-II behaviour and worry scores were 8.2 (SD: 9.9) and 7.3 (SD: 11.8), respectively. Increased fear of hypoglycaemia was significantly associated with lower SF-36v2 scores. Several patient-, disease- and treatment-related characteristics correlated with HRQoL, indicating that a multifactorial approach is needed to maintain HRQoL in patients with T2D.