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Quality of life, health status and clinical outcomes in Type 2 diabetes patients

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An Erratum to this article was published on 03 March 2007


This study examines relationships between patient reported outcomes (PROs) and clinical outcomes in Type 2 diabetes mellitus (T2DM). Patients at the outpatient clinics of a university hospital completed measures of generic health status (SF-12), diabetes-specific quality of life (Audit of Diabetes Dependent Quality of Life – ADDQoL), and depressive symptoms (Center for Epidemiologic Studies Depression – CES-D). Patient reported data were merged with a retrospective collection of clinical and utilization data, including HbA1C, from electronic medical records. A Charlson comorbidity score, diabetes complications score, BMI, and total number of ER and hospital visits were calculated. Usable response rate was 44.3% (n = 385). Patients were dichotomized into glycemic control levels based on the ADA recommended A1C level  < 7.0, vs.  ≥ 7.0. The ADDQoL, PCS-12, and MCS-12 scores were separately examined as dependent variables using hierarchical regression models, with glycemic control as the primary explanatory variable, and controlling for demographics and clinical variables including comorbidities and complications. Glycemic control was not a significant predictor in any regression model. Obesity was a significant predictor leading to poorer PCS-12 and MCS-12 scores, while depressive symptoms significantly resulted in lower PCS-12, MCS-12 and ADDQoL scores. These and other factors related to self-management behaviors may contribute to a greater understanding of how to intervene with patients with T2DM. The use of such PROs alongside biomedical measures such as A1C is recommended.

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American Diabetes Association


Audit of Diabetes Dependent Quality of Life


Analysis of Variance


Body Mass Index


Center for Epidemiologic Studies-Depression


Diabetes Control and Complications Trial


Electronic Medical Records


Emergency Room


Health-Related Quality of Life


International Classification of Diseases 9th revision


Mental Component Summary-12


Patient Reported Outcomes


Physical Component Summary-12


Quality of Life


Medical Outcomes Study Short-Form 12


United Kingdom Prospective Diabetes Study


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The authors would like to acknowledge the coordination support provided by the Office of Medical Staff Affairs and the Department of Family Medicine at the West Virginia University Hospitals, in contacting the patients and in obtaining medical history information. We are also grateful to Clare Bradley (Royal Holloway Department of Psychology), and to QualityMetric Inc. for providing us with academic licenses for the use of the ADDQoL and the SF-12, respectively.

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Correspondence to Murali Sundaram.

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An erratum to this article can be found at

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Sundaram, M., Kavookjian, J., Patrick, J. et al. Quality of life, health status and clinical outcomes in Type 2 diabetes patients. Qual Life Res 16, 165–177 (2007).

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