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Quality of life along the diabetes continuum: a cross-sectional view of health-related quality of life and general health status in middle-aged and older Finns

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Abstract

Purpose

To examine the general health status and health-related quality of life (HRQOL) along the diabetes continuum of middle-aged and older Finns, and to determine the glucose metabolism stage by which the HRQOL has decreased noticeably.

Methods

The cross-sectional sample consisted of 920 persons aged 51–75 from the general population in a single municipality in a rural area of Eastern Finland. Data were adjusted for age, sex, smoking history, current alcohol consumption, employment and marital status. The HRQOL and health status were evaluated using two preference-based HRQOL instruments, 15D and SF-6D, and one health profile instrument, 36-Item Short Form Health Survey (SF-36).

Results

Individuals with impaired glucose tolerance (IGT) and type 2 diabetes had noticeably low mean SF-6D, 15D and general health status. The decrease in overall HRQOL was mainly due to a decline in the physical dimensions of HRQOL. The adjusted odds ratios (95 % CI) for having noticeably low HRQOL on SF-6D, 15D and general health dimension of SF-36 associated with IGT were 1.95 (1.18–3.25), 1.35 (0.84–2.18) and 2.00 (1.21–3.29), respectively.

Conclusions

The progression along the diabetes continuum was significantly associated with a decrease in HRQOL and health status. Furthermore, the data indicate that when a person is detected to have IGT, the HRQOL and general health status have already diminished noticeably. The prevailing evidence suggests that detection and intervention before a patient develops IGT is essential in order to minimize the loss of quality of life and quality-adjusted life years.

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Abbreviations

BDI:

Becks Depression Inventory-scale

HRQOL:

Health-related quality of life

ICD-10:

International classification of diseases, 10th revision

IFG:

Increased fasting glucose

IGM:

Impaired glucose metabolism

IGT:

Impaired glucose tolerance

MID:

Minimally important difference

NDM:

Newly diagnosed type 2 diabetes

OGTT:

Oral glucose tolerance test

QALY:

Quality-adjusted life year

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Acknowledgments

The authors wish to thank the study nurses for their valuable work in organizing and performing the examinations of the study subjects and the study subjects for their time and effort. This study was partly supported by grant from the South Karelia District of Social and Health Services.

Conflict of interest

Mr. Väätäinen declares no conflict of interest. Dr. H. Tuomilehto is a clinical specialist and founding partner of Oivauni Sleep Clinic, which provides clinical services for people with sleep disorders. Dr. Saramies, Dr. Hussi, Dr. Uusitalo and Dr. Keinänen-Kiukaanniemi declare no conflict of interest. Dr. J. Tuomilehto has received speaker’s fee from AstraZeneca, Bayer Healthcare and Novo Nordisk. Dr. Martikainen is a senior partner of ESiOR Oy, which performs studies and health economic evaluations for several pharmaceutical companies, food industry companies, medical device companies, hospitals, and academic institutions.

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Authors and Affiliations

  1. Pharmacoeconomics and Outcomes Research Unit, Faculty of Health Sciences, School of Pharmacy, Social Pharmacy, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland

    Saku Väätäinen & Janne Martikainen

  2. Institute of Health Sciences, University of Oulu, Oulu, Finland

    Sirkka Keinänen-Kiukaanniemi

  3. Oulu University Hospital, Oulu, Finland

    Sirkka Keinänen-Kiukaanniemi

  4. South Karelia Central Hospital, Lappeenranta, Finland

    Jouko Saramies

  5. Department of Ophthalmology, School of Medicine, University of Tampere, Tampere, Finland

    Hannu Uusitalo

  6. Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland

    Jaakko Tuomilehto

  7. Department of Public Health, University of Helsinki, Helsinki, Finland

    Jaakko Tuomilehto

Authors
  1. Saku Väätäinen
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  2. Sirkka Keinänen-Kiukaanniemi
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  3. Jouko Saramies
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  4. Hannu Uusitalo
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  5. Jaakko Tuomilehto
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  6. Janne Martikainen
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Corresponding author

Correspondence to Saku Väätäinen.

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Väätäinen, S., Keinänen-Kiukaanniemi, S., Saramies, J. et al. Quality of life along the diabetes continuum: a cross-sectional view of health-related quality of life and general health status in middle-aged and older Finns. Qual Life Res 23, 1935–1944 (2014). https://doi.org/10.1007/s11136-014-0638-3

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  • DOI: https://doi.org/10.1007/s11136-014-0638-3

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