Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study
- 1.3k Downloads
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.
KeywordsDiagnosis of diabetes Health-related quality of life Pre-diabetes Type 2 diabetes mellitus Prevention
- 2.Garratt, A., Schmidt, L., Mackintosh, A., & Fitzpatrick, R. (2002). Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ, 324(1417), 1.Google Scholar
- 7.Biondi, B., Palmieri, E. A., Fazio, S., Cosco, C., Nocera, M., Sacca, L., et al. (2000). Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients. Journal of Clinical Endocrinology and Metabolism, 85, 4701–4705.PubMedGoogle Scholar
- 11.Adriaanse, M. C., Dekker, J. M., Spijkerman, A. M. W., Twisk, J. W. R., Nijpels, G., van der Ploeg, H. M., et al. (2004). Health-related quality of life in the first year following diagnosis of type 2 diabetes: newly diagnosed patients in general practice compared with screening-detected patients. The Hoorn Screening Study. Diabetic Medicine, 21, 1075–1081.PubMedCrossRefGoogle Scholar
- 15.Adriaanse, M. C., Dekker, J. M., Spikerman, A. M. W., Twisk, J. W. R., Nijpels, G., van der Ploeg, H. M., et al. (2004). Health-related quality of life in the first year following diagnosis of type 2 diabetes: newly diagnosed patients in general practice compared with screening-detected patients. The Hoorn Screening Study. Diabetic Medicine, 21(10), 1075–1081.PubMedCrossRefGoogle Scholar
- 24.Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. (1997). Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care, 20, 1183–1197.Google Scholar
- 27.Kriska, A.M., Caspersen, C.J. (1997). Introduction to the collection of physical activity questionnaires in a collection of physical activity questionnaires for health-related research. In: Kriska, A.M., Caspersen, C.J. (Eds.), Centers for Disease Control and Prevention. Medicine and Science in Sports and Exercise, 29(Supp), S5–S9.Google Scholar
- 29.Verbeke, G., & Molenberghs, G. (2009). Linear mixed models for longitudinal data. New York: Springer.Google Scholar
- 33.Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical and mental health summary scales: A user’s manual. Boston: The Health Institute, New England Medical Center.Google Scholar
- 34.Hopman, W. M., Berger, C., Joseph, L., Towheed, T., VandenKerkhof, E., Anastassiades, T., et al. (2006). The natural progression of health related quality of life: Results of a five-year prospective study of the SF-36 scores in a normative population. Quality of Life Research, 15, 527–536.PubMedCrossRefGoogle Scholar