Quality of Life Research

, Volume 22, Issue 6, pp 1245–1253

Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy

  • Flavio E. Hirai
  • James M. Tielsch
  • Barbara E. K. Klein
  • Ronald Klein

DOI: 10.1007/s11136-012-0245-0

Cite this article as:
Hirai, F.E., Tielsch, J.M., Klein, B.E.K. et al. Qual Life Res (2013) 22: 1245. doi:10.1007/s11136-012-0245-0



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.


Epidemiology Diabetes mellitus Quality of life Diabetic retinopathy 

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Flavio E. Hirai
    • 1
    • 2
  • James M. Tielsch
    • 3
  • Barbara E. K. Klein
    • 4
  • Ronald Klein
    • 4
  1. 1.Department of Epidemiology, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  2. 2.Department of OphthalmologyFederal University of Sao PauloSao PauloBrazil
  3. 3.Department of International Health, Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA
  4. 4.Department of Ophthalmology and Visual SciencesUniversity of Wisconsin-MadisonMadisonUSA

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