Quality of Life Research

, Volume 23, Issue 1, pp 75-88

First online:

Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study

  • D. MarreroAffiliated withIndiana University School of MedicineDPP Coordinating Center, The Biostatistics Center, George Washington University Email author 
  • , Q. PanAffiliated withDPP Coordinating Center, The Biostatistics Center, George Washington University
  • , E. Barrett-ConnorAffiliated withDepartment of Family Medicine, University of California
  • , M. de GrootAffiliated withIndiana University School of Medicine
  • , P. ZhangAffiliated withCenters for Disease Control and Prevention
  • , C. PercyAffiliated withNorthern Navajo Medical Center
  • , H. FlorezAffiliated withUniversity of Miami Miller School of Medicine
  • , R. AckermannAffiliated withDepartment of Medicine, Northwestern University
  • , M. MontezAffiliated withUniversity of Texas Health Science Center
    • , R. R. RubinAffiliated withDepartments of Medicine and Pediatrics, The Johns Hopkins School of Medicine
    • , the DPPOS Research Group

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The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration.


3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared.


PCS and SF-6D scores declined in all participants in all treatment arms (P < .001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P < .001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P < .001) and two years (P < .001) post-diagnosis.


Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes.


Diagnosis of diabetes Health-related quality of life Pre-diabetes Type 2 diabetes mellitus Prevention