Quality of Life Research

, Volume 14, Issue 5, pp 1311–1320

Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey

  • Sheri L. Maddigan
  • David H. Feeny
  • Jeffrey A. Johnson

DOI: 10.1007/s11136-004-6640-4

Cite this article as:
Maddigan, S.L., Feeny, D.H. & Johnson, J.A. Qual Life Res (2005) 14: 1311. doi:10.1007/s11136-004-6640-4


Objective: To assess the impact of comorbid heart disease, stroke and arthritis on health-related quality of life (HRQL) in people with diabetes in the general Canadian population. Methods: Data were collected as part of the 1996–1997 Canadian National Population Health Survey. HRQL was assessed using overall Health Utilities Index Mark 3 (HUI3) and single attribute utility scores. Respondents (N=66,093) were classified into 1 of 16 groups based on the presence or absence of diabetes, heart disease, stroke, and arthritis, in all possible combinations and HRQL scores were compared using analysis of covariance. Results: Overall HUI3 scores for respondents with diabetes alone (0.88, 95 CI: 0.87–0.89) were lower than controls (0.92 95 CI: 0.92–0.92, p < 0.001). Overall HUI3 scores for diabetes in combination with␣heart disease (0.77, 95 CI: 0.74–0.79), arthritis (0.78, 95 CI: 0.77–0.79) or stroke (0.79, 95 CI: 0.74–0.85) were considerably lower than diabetes alone. Triplets of comorbidities were associated with overall HRQL deficits of approximately 0.26–0.30, relative to controls. Conclusions: The illness burden experienced by individuals with diabetes is not only associated with diabetes itself, but largely with comorbid medical conditions.


ComorbidityDiabetesHealth statesQuality of lifePopulation healthSurvey research



Analysis of Covariance


Body Mass Index


Health Related Quality of Life

HUI3 -

Health Utilities Index Mark 3


National Population Health Survey

95 CI

95 Confidence Interval

Copyright information

© Springer 2005

Authors and Affiliations

  • Sheri L. Maddigan
    • 1
    • 2
  • David H. Feeny
    • 1
    • 2
    • 3
    • 4
  • Jeffrey A. Johnson
    • 1
    • 2
    • 2
  1. 1.Department of Public Health SciencesUniversity of AlbertaEdmontonCanada
  2. 2.Institute of Health EconomicsEdmontonCanada
  3. 3.Department of EconomicsUniversity of AlbertaEdmontonCanada
  4. 4.Health Utilities Inc.Ontario