Skip to main content

Advertisement

Log in

Change in perceived health and functioning over time in patients with type I diabetes mellitus

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Objective: The objective of this study was to investigate perceived health and functioning (PHF) of patients with type I diabetes mellitus (DMT1) over time and to compare change in perceived PHF with that of a sample of the general population. Methods: In a Dutch cohort of 234 patients with DMT1 we assessed PHF over time with two generic instruments: RAND-36 and EuroQol. We applied multilevel modelling to estimate change in PHF over the years 1995–2001. We compared change in PHF with change estimated from a comparably aged sample from the general population using a one-sample t-test. Results: Patients reported a significant decrease in PHF for most RAND-36 subscales. Mean changes in RAND–36 scores ranged from −0.09 (mental health) to −1.18 per year (bodily pain). EQ scores decreased significantly as well. Patients in the cohort had a faster decrease in three RAND-36 subscales and EQ-VAS over time than the estimated decrease in the general population. Conclusion: This study showed that patients with DMT1 have a faster decrease in PHF over time than comparably aged persons from the general population. The generic instruments used in our study were sensitive enough to measure changes in PHF over time in an adult diabetes population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • MA Atkinson NK Maclaren (1994) ArticleTitleThe pathogenesis of insulin-dependent diabetes mellitus. N Engl J Med 331 1428–1436 Occurrence Handle10.1056/NEJM199411243312107 Occurrence Handle7969282

    Article  PubMed  Google Scholar 

  • MA Atkinson GS Eisenbarth (2001) ArticleTitleType I diabetes: New perspectives on disease pathogenesis and treatment. The Lancet 358 221–229 Occurrence Handle10.1016/S0140-6736(01)05415-0

    Article  Google Scholar 

  • InstitutionalAuthorNameDCCT (1993) ArticleTitleThe effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med 329 977–986

    Google Scholar 

  • C Bradley (2001) ArticleTitleImportance of differentiating health status from quality of life. The Lancet 357 7–8 Occurrence Handle10.1016/S0140-6736(00)03562-5

    Article  Google Scholar 

  • R Klein BE Klein (1998) ArticleTitleRelation of glycemic control to diabetic complications and health outcomes. Diabetes Care 21 (Suppl. 3) C39–C43

    Google Scholar 

  • AM Aalto A Uutela T Kangas (1996) ArticleTitleHealth behaviour, social integration, perceived health and dysfunction. A comparison between patients with type I and II diabetes and controls. Scand J Soc Med 24 272–281 Occurrence Handle8983099

    PubMed  Google Scholar 

  • AM Aalto A Uutela AR Aro (1997) ArticleTitleHealth related quality of life among insulin-dependent diabetics: Disease-related and psychosocial correlates. Patient Educ Couns 30 215–225 Occurrence Handle10.1016/S0738-3991(96)00963-9 Occurrence Handle9104378

    Article  PubMed  Google Scholar 

  • MJ Bardsley S Astell A McCallum PD Home (1993) ArticleTitleThe performance of three measures of health status in an outpatient diabetes population. Diabet Med 10 619–626 Occurrence Handle8403822

    PubMed  Google Scholar 

  • U Bott I Muhlhauser H Overmann M Berger (1998) ArticleTitleValidation of a diabetes-specific quality-of-life scale for patients with type 1 diabetes. Diabetes Care 21 757–769 Occurrence Handle9589237

    PubMed  Google Scholar 

  • RE Glasgow L Ruggiero EG Eakin J Dryfoos L Chobanian (1997) ArticleTitleQuality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care 20 562–567 Occurrence Handle9096981

    PubMed  Google Scholar 

  • BR Hanestad (1993) ArticleTitleSelf-reported quality of life and the effect of different clinical and demographic characteristics in people with type 1 diabetes. Diabetes Res Clin Pract 19 139–149 Occurrence Handle10.1016/0168-8227(93)90107-G Occurrence Handle8472629

    Article  PubMed  Google Scholar 

  • AM Jacobson Groot M de JA Samson (1994) ArticleTitleThe evaluation of two measures of quality of life in patients with type I and type II diabetes. Diabetes Care 17 267–274 Occurrence Handle8026281

    PubMed  Google Scholar 

  • AM Jacobson M Groot Particlede JA Samson (1997) ArticleTitleThe effects of psychiatric disorders and symptoms on quality of life in patients with type I and type II diabetes mellitus. Qual Life Res 6 11–20 Occurrence Handle10.1023/A:1026487509852 Occurrence Handle9062437

    Article  PubMed  Google Scholar 

  • LA Kent GV Gill G Williams (1994) ArticleTitleMortality and outcome of patients with brittle diabetes and recurrent ketoacidosis. Lancet 344 778–781 Occurrence Handle10.1016/S0140-6736(94)92340-X Occurrence Handle7916072

    Article  PubMed  Google Scholar 

  • I Muhlhauser H Overmann R Bender et al. (1998) ArticleTitleSocial status and the quality of care for adult people with type I (insulin-dependent) diabetes mellitus–a population-based study. Diabetologia 41 1139–1150 Occurrence Handle10.1007/s001250051043 Occurrence Handle9794099

    Article  PubMed  Google Scholar 

  • GR Parkerson ParticleJr RT Connis WE Broadhead DL Patrick TR Taylor CK Tse (1993) ArticleTitleDisease-specific vs. generic measurement of health-related quality of life in insulin-dependent diabetic patients. Med Care 31 629–639 Occurrence Handle8326776

    PubMed  Google Scholar 

  • J Reviriego MD Millan M Millan (1996) ArticleTitleEvaluation of the diabetes quality-of-life questionnaire in a Spanish population. An experience of translation and reliability. Pharmacoeconomics 10 614–622 Occurrence Handle10164061

    PubMed  Google Scholar 

  • PE Wandell B Brorsson H Aberg (1998) ArticleTitleQuality of life among diabetic patients in Swedish primary health care and in the general population: Comparison between 1992 and 1995. Qual Life Res 7 751–760 Occurrence Handle10.1023/A:1008893121086 Occurrence Handle10097623

    Article  PubMed  Google Scholar 

  • K Wikblad J Leksell L Wibell (1996) ArticleTitleHealth-related quality of life in relation to metabolic control and late complications in patients with insulin dependent diabetes mellitus. Qual Life Res 5 123–130 Occurrence Handle10.1007/BF00435977 Occurrence Handle8901375

    Article  PubMed  Google Scholar 

  • SY Wu F Sainfort RH Tomar et al. (1998) ArticleTitleDevelopment and application of a model to estimate the impact of type 1 diabetes on health-related quality of life. Diabetes Care 21 725–731 Occurrence Handle9589231

    PubMed  Google Scholar 

  • CE Lloyd TJ Orchard (1999) ArticleTitlePhysical and psychological well-being in adults with type 1 diabetes. Diabetes Res Clin Pract 44 9–19 Occurrence Handle10.1016/S0168-8227(99)00004-2 Occurrence Handle10414935

    Article  PubMed  Google Scholar 

  • F Pouwer HM Ploeg Particlevan der HJ Ader RJ Heine FJ Snoek (1999) ArticleTitleThe 12-item well-being questionnaire. An evaluation of its validity and reliability in Dutch people with diabetes. Diabetes Care 22 2004–2010 Occurrence Handle10587834

    PubMed  Google Scholar 

  • J Hahl H Hamalainen H Sintonen T Simell S Arinen O Simell (2002) ArticleTitleHealth related quality of life in type I diabetes without or with symptoms of long-term complications. Qual Life Res 11 427–436 Occurrence Handle10.1023/A:1015684100227 Occurrence Handle12113390

    Article  PubMed  Google Scholar 

  • H Hart H Bilo W Redekop R Stolk J Assink Jong B Meyboom-de (2003) ArticleTitleQuality of life of patients with type I diabetes mellitus. Qual Life Res 12 1089–1097 Occurrence Handle10.1023/A:1026197119569 Occurrence Handle14651426

    Article  PubMed  Google Scholar 

  • DCCT. Influence of intensive diabetes treatment on quality-of-life outcomes in the diabetes control and complications trial. Diabetes Care 1996; 19: 195–203.

  • R Hays C Sherbourne R Mazel (1993) ArticleTitleThe RAND 36-item Health Survey 1.0. Health Econ 2 217–227 Occurrence Handle8275167

    PubMed  Google Scholar 

  • Zee vdKI, Sanderman R. Het meten van de algemene gezondheidstoestand met de RAND-36. Een handleiding [Measuring general state of health with the RAND-36. A guide]. Noordelijk Centrum voor gezondheidsvraagstukken. Rijksuniversiteit Groningen [Northern Centre for Healthcare research (NCH), University of Groningen] 1993; 1–28.

  • JE Ware M Kosinski MS Bayliss CA McHorney WH Rogers A Raczek (1995) ArticleTitleComparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: Summary of results from the Medical Outcomes Study. Med Care 33 AS264–AS279 Occurrence Handle7723455

    PubMed  Google Scholar 

  • J Ware (2000) ArticleTitleSF-36 Health Survey Update. Spine 25 3130–3139 Occurrence Handle10.1097/00007632-200012150-00008 Occurrence Handle11124729

    Article  PubMed  Google Scholar 

  • NK Aaronson M Muller PD Cohen et al. (1998) ArticleTitleTranslation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 51 1055–1068 Occurrence Handle10.1016/S0895-4356(98)00097-3 Occurrence Handle9817123

    Article  PubMed  Google Scholar 

  • vdKI Zee R Sanderman J Heyink dH Haes (1996) ArticleTitleThe psychometric qualities of the RAND 36-item Health Survey 1.0: A multidimensional measure of general health status. Int J Behav Med 3 104–122

    Google Scholar 

  • Group EuroQol (1990) ArticleTitleEuroQol-a new facility for the measurement of health related quality of life. The EuroQol Group. Health Policy 16 199–208

    Google Scholar 

  • P Dolan (1996) ArticleTitleModelling valuations for health states: The effect of duration. Health Policy 38 189–203 Occurrence Handle10162421

    PubMed  Google Scholar 

  • ML Essink-Bot ME Stouthard GJ Bonsel (1993) ArticleTitleGeneralizability of valuations on health states collected with the EuroQol-questionnaire. Health Econ 2 237–246 Occurrence Handle8275169

    PubMed  Google Scholar 

  • InstitutionalAuthorNameDutch Advisory on Health Research. (1991) Advice on Chronic Diseases: Priorities for Research ‘s Gravenhage The Netherlands

    Google Scholar 

  • dPTVM Jong (1993) ArticleTitleScreening op diabetische retinopathie [Screening for diabetic retinopathy]. Nederlands Tijdschrift voor Geneeskunde 137 1701–1705 Occurrence Handle8371809

    PubMed  Google Scholar 

  • JJ Holewski RM Stess PM Graf C Grunfeld (1988) ArticleTitleAesthesiometry: Quantification of cutaneous pressure sensation in diabetic peripheral neuropathy. J Rehabil Res Dev 25 1–10

    Google Scholar 

  • CBO NDF. Diabetische retinopathie, diabetische nefropathie, diabetische voet, harten vaatziekten bij diabetes mellitus [Diabetic retinopathy, diabetic nephropathy, diabetic foot, cardiac and vascular pathology in diabetes mellitus], 1998.

  • InstitutionalAuthorNameEURODIAB (1994) ArticleTitleMicrovascular and acute complications in IDDM patients: The EURODIAB IDDM Complications Study. Diabetologia 37 278–285

    Google Scholar 

  • P Reichard BY Nilsson U Rosenqvist (1993) ArticleTitleThe effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med 329 304–309 Occurrence Handle10.1056/NEJM199307293290502 Occurrence Handle8147960

    Article  PubMed  Google Scholar 

  • J Singer (1998) ArticleTitleUsing SAS PROC MIXED to fit multilevel modesl, hierarchical models, and individual growth models. J Educ behav Stat 24 323–355

    Google Scholar 

  • R Crosby R Kolotkin G Williams (2003) ArticleTitleDefining clinically meaningful change in health-related quality of life. J Clin Epidemiol 56 395–407 Occurrence Handle10.1016/S0895-4356(03)00044-1 Occurrence Handle12812812

    Article  PubMed  Google Scholar 

  • D Rubin (1976) ArticleTitleInference and missing data. Biometrika 63 581–592

    Google Scholar 

  • R Brook J Ware W Rogers E Keeler A Davies C Donald et al. (1983) ArticleTitleDoes free care improve adults’health? Results from a Randomized Controlled Trial. N Eng J Med 309 1426–1434

    Google Scholar 

  • R Hays L Morales (2001) ArticleTitleThe RAND-36 measure of health related quality of life. Ann Med 33 350–357 Occurrence Handle11491194

    PubMed  Google Scholar 

  • JE Ware M Kosinki (2001) ArticleTitleInterpreting SF-36 summary health measures: A response. Qual Life Res 10 405–413 Occurrence Handle10.1023/A:1012588218728 Occurrence Handle11763203

    Article  PubMed  Google Scholar 

  • P Kind G Hardman S Macran (1999) UK Population Norms for EQ-5D. Centre for Health Economics, University of York UK

    Google Scholar 

  • J Bland D Altman (1995) ArticleTitleMultiple significance tests: The Bonferroni method. Br Med J 310 170

    Google Scholar 

  • RT Anderson NK Aaronson M Bullinger WL McBee (1996) ArticleTitleA review of the progress towards developing health related quality of life instruments for international clinical studies and outcomes research. Pharmacoeconomics 10 336–355 Occurrence Handle10163577

    PubMed  Google Scholar 

  • IB Wilson PD Cleary (1995) ArticleTitleLinking clinical variables with health-related quality of life. A conceptual model of patient outcomes. J Am Med Assoc 273 59–65 Occurrence Handle10.1001/jama.273.1.59

    Article  Google Scholar 

  • A Woodcock S Julious A Kinmouth M Campbell (2001) ArticleTitleProblems with the performance of the SF-36 among people with type 2 diabetes in general practice. Qual Life Res 10 661–670 Occurrence Handle10.1023/A:1013837709224 Occurrence Handle11871587

    Article  PubMed  Google Scholar 

  • E Leventhal T- Prohaska (1986) ArticleTitleAge, symptom interpretation, and health behavior. J Am Geriatr Soc 34 185–191 Occurrence Handle3950286

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Huberta E. Hart.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hart, H.E., Redekop, W.K., Bilo, H.J. et al. Change in perceived health and functioning over time in patients with type I diabetes mellitus. Qual Life Res 14, 1–10 (2005). https://doi.org/10.1007/s11136-004-0782-2

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-004-0782-2

Keywords

Navigation