Abstract
BackgroundThe aim of this study was to describe how diabetes complications influence the health-related quality of life of individuals with diabetes using the individual EQ-5D dimensions and the EQ-5D index.MethodsWe mailed a questionnaire to 1,000 individuals with diabetes type 1 and 2 in Norway. The questionnaire had questions about socio-demographic characteristics, use of health care, diabetes complications and finally the EQ-5D descriptive system. Logistic regressions were used to explore determinants of responses in the EQ-5D dimensions, and robust linear regression was used to explore determinants of the EQ-5D index.ResultsIn multivariate analyses the strongest determinants of reduced MOBILITY were neuropathy and ischemic heart disease. In the ANXIETY/DEPRESSION dimension of the EQ-5D, "fear of hypoglycaemia" was a strong determinant. For those without complications, the EQ-5D index was 0.90 (type 1 diabetes) and 0.85 (type 2 diabetes). For those with complications, the EQ-5D index was 0.68 (type 1 diabetes) and 0.73 (type 2 diabetes). In the linear regression the factors with the greatest negative impact on the EQ-5D index were ischemic heart disease (type 1 diabetes), stroke (both diabetes types), neuropathy (both diabetes types), and fear of hypoglycaemia (type 2 diabetes).ConclusionsThe EQ-5D dimensions and the EQ-5D seem capable of capturing the consequences of diabetes-related complications, and such complications may have substantial impact on several dimensions of health-related quality of life (HRQoL). The strongest determinants of reduced HRQoL in people with diabetes were ischemic heart disease, stroke and neuropathy.
Highlights
The aim of this study was to describe how diabetes complications influence the health-related quality of life of individuals with diabetes using the individual EQ-5D dimensions and the EQ-5D index
In addition to diabetes-related complications, episodes of hypoglycaemia, fear of hypoglycaemia, change in life style and fear of long term consequences may lead to reduced health-related quality of life (HRQoL)
We found no effect of age or body mass index in the linear regressions whether age and BMI were entered as one continuous variable or as dummy variables
Summary
The aim of this study was to describe how diabetes complications influence the health-related quality of life of individuals with diabetes using the individual EQ-5D dimensions and the EQ-5D index. Numerous disease-specific HRQoL measures exist for diabetes, and these score HRQoL on ordinal scales [6,7,8] Generic instruments such as the Short Form 36 (SF-36) are used [9]. In multiattribute utility instruments (MAU), such as the EQ-5D [10], 15D [11], Health Utility index (HUI) [12,13] and SF6D [14], respondents indicate levels of health problems on a number of dimensions of health. These values are translated into a zero-one scale where zero denotes death and one perfect health. QALYs can be calculated for different patient groups to compare for example effectiveness of treatment, enabling health improvements and life extensions to be captured in one single variable
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