Abstract
BackgroundHealth-related quality of life studies among adults with type 2 diabetes mellitus, using the EQ-5D, have been short term and have not assessed change over years. This study assessed the change in health status and health-related quality of life over 5 years among individuals with and without diabetes.MethodsRespondents to the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) completed the EuroQol-5D (EQ-5D) at baseline (2004) and 5 years later (2009). Visual analog scale (VAS) score and health index score were computed at baseline and year 5, and the change over 5 years was measured for individuals with type 2 diabetes mellitus (T2DM) and those without diabetes, and T2DM adults with and without diabetic complications. Linear regression models were used to determine change in EQ-5D score, controlling for age, gender, race, education, household income, and body mass index (BMI).ResultsThere was significantly greater decline in the EQ-5D index score in the T2DM group (-0.031 [SD 0.158]), compared with those without diabetes (-0.016 [0.141], p = 0.001). Compared with respondents without diabetes, those with T2DM had a larger reduction in EQ-5D index score, after controlling for demographics (p = 0.001). EQ-5D VAS score declined over 5 years for both groups: -1.42 (18.1) for the T2DM group, and -0.63 (15.8) for the group without diabetes, but the between-group difference was not significant either before (p = 0.09) or after (p = 0.12), controlling for demographics. T2DM respondents with diabetic complications had a greater decline in EQ-5D scores than T2DM respondents without complications (p < 0.05).ConclusionOver a 5-year period, health status of respondents with T2DM declined significantly compared with those with no diabetes, indicating that the burden of the disease has a long-term detrimental impact. This decline in health status is likely to impact utility scores (fewer quality-adjusted life years) for economic evaluations.
Highlights
Health-related quality of life studies among adults with type 2 diabetes mellitus, using the EQ-5D, have been short term and have not assessed change over years
Assessments of health-related quality of life (HRQOL) using generic instruments like the EQ-5D allow for comparisons with other chronic diseases as well as comparisons with healthy populations to estimate the incremental burden of diabetes. The objective of this present study was to assess the change in health status and HRQOL over a 5-year period among adults with and without type 2 diabetes mellitus (T2DM), using data from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD)
This study evaluated change in HRQOL over 5 years among adults being treated in routine clinical practice
Summary
Health-related quality of life studies among adults with type 2 diabetes mellitus, using the EQ-5D, have been short term and have not assessed change over years. Individuals with T2DM are known to have lower health-related quality of life (HRQOL) and more depressive symptomatology than those without diabetes [5,6,7,8]. In a population-based study of adults with and without T2DM, investigators found EQ-5D index scores and visual analog scores were significantly lower for respondents with T2DM and those with 3−5 risk factors for T2DM than for those with 0−2 risk factors [9] The majority of these HRQOL studies in diabetes has focused on the current health state of patients and has not assessed change in health state over long periods of time, except for clinical trials that are short term
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