Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy
To investigate a 10-year change of quality of life and associated factors in a population with type 1 diabetes.
The Medical Outcome Study Short Form-36 (SF-36) was administered in participants (n = 520) at the 1995–1996 and 2005–2007 examination phases of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Physical (PCS) and mental (MCS) component summary scores were calculated. The associations between changes of quality of life and demographic, socioeconomic, and clinical factors were analyzed.
PCS score decreased (p < 0.001) and MCS score increased (p < 0.001) after 10 years. The development of cardiovascular disease and the presence of limb amputation were associated with decrease in the PCS score. Those who were working and retired had increased MCS; those who were working and stopped had a decrease in the MCS score. Change in visual acuity and diabetic retinopathy status did not have a significant impact in health-related quality of life scores.
Our findings reinforce the necessity to make every attempt to decrease complications of diabetes in individuals with long-term type 1 diabetes in order to attenuate the diminished quality of life associated with those complications such as cardiovascular disease. Change in employment status, likely due to development of these complications, was also strongly associated with poorer quality of life and suggests the benefits of preventing or decreasing complications to keep people with type 1 diabetes in the workforce.
KeywordsEpidemiology Diabetes mellitus Quality of life Diabetic retinopathy
The study was supported by the National Institutes of Health (Bethesda, MD) Grant No. EY06594 and EY016379 (R Klein, BEK Klein) and, in part, by Research to Prevent Blindness (R. Klein and BEK Klein, Senior Scientific Investigator Awards), New York (NY). The National Eye Institute provided funding for entire study including collection and analyses of data; RPB provided further additional support for data analyses. This research was also supported by the Mentor-based Post-doctoral Fellowship Award from the American Diabetes Association, Alexandria, VA (to R.K.).
Conflict of interest
The authors have no conflict of interest to disclose.
- 11.Klein, R., Klein, B. E., Moss, S. E., Davis, M. D., & DeMets, D. L. (1989). The Wisconsin Epidemiologic Study of Diabetic Retinopathy. IX. Four-year incidence and progression of diabetic retinopathy when age at diagnosis is less than 30 years. Archives of Ophthalmology, 107(2), 237–243.PubMedCrossRefGoogle Scholar
- 13.Klein, R., Klein, B. E., Moss, S. E., & Cruickshanks, K. J. (1998). The Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology, 105(10), 1801–1815.PubMedCrossRefGoogle Scholar
- 15.The Early Treatment Diabetic Retinopathy Study Group. In: ETDRS Coordinating Center, ed. Early Treatment Diabetic Retinopathy Study: Manual of Operations: Department of Epidemiology and Preventive Medicine University of Maryland Baltimore; 1985.Google Scholar
- 16.Quick Step. (1981). Fast Hemoglobin Test System. 1-8.Google Scholar
- 17.Ware, J. E., Kosinski, M., & Gandek, B. (1993). SF-36 Health survey: manual & interpretation guide. Lincoln, RI: QualityMetric Incorporated.Google Scholar
- 18.Ware J. E. Scoring Algorithms. In: Ware JE, Kosinski MA, Keller SD, eds. SF-36 Physical and Mental Health Summary Scales: A User’s Manual. Boston: The Health Institute, New England Medical Center; 1994.Google Scholar
- 19.Early Treatment Diabetic Retinopathy Study Research Group. (1991). Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12.. Ophthalmology, 98(5 Suppl), 823-833.Google Scholar
- 20.Early Treatment Diabetic Retinopathy Study Research Group. (1991). Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7. Ophthalmology, 98(5 Suppl), 741-756.Google Scholar