Health-Related Quality of Life of Type 2 Diabetes Inpatients with Diabetes-Related Complications in China

Abstract

Background: Quite a few studies have evaluated the health-related quality of life (HRQOL) of type 2 diabetes patients, but few focus on inpatients with diabetes-related complications in relative serious condition. Reliable estimates of the impact of complications on HRQOL are important to understand the event burden and serve for economic evaluation. This study aims to estimate the utility-based HRQOL of type 2 diabetes inpatients with eight major complications in China; and quantify the utility decrement due to a certain complication. Methods: This is a cross-sectional study. Type 2 diabetes inpatients being hospitalized for their complications, including ischaemic heart disease (IHD), acute myocardial infarction (AMI), congestive heart failure (CHF), stroke, low vision (LV), end-stage renal disease (ESRD), ulcer or amputation; and type 2 diabetes outpatients without complications were recruited from a tertiary hospital in China during January to May 2017. EuroQOL 5-dimensions 3-level instrument was administered to these patients through face-to-face interviews. Socio-demographic and disease specific data were collected from the survey. One-way analysis of variance and multiple linear regression analysis were performed. Findings: 802 inpatients with complications (mean age: 62·67 years, female proportion: 43%) and 66 outpatients without complications (mean age: 46·52 years, female proportion: 50%) were included. Mean utilitybased HRQOL was 0·923 for patients without complications, while 0·562 for inpatients with a certain complication. Utility varied between complications with significant differences: IHD=0·620, AMI=0·434, CHF=0·471, stroke=0·472, LV=0·714, ESRD=0·693, ulcer=0·431, and amputation=0·395. Regression results showed that utility decrement associated with IHD was 0·269, AMI=0·460, CHF=0·399, stroke=0·413, LV=0·174, ESRD=0·192, ulcer=0·444, amputation=0·489. Interpretation: HRQOL of type 2 diabetes inpatients with complication was considerable impaired. Inpatients with amputation were associated with the greatest utility decrement, followed by AMI and ulcer. Funding funding was received for this study. Funding Statement: The authors state: No funding was received for this study. Declaration of Interests: The authors state: There are no relevant conflicts of interest to disclose. Ethics Approval Statement: This was a cross-sectional study. The study was reviewed and approved by the Medical Faculty Ethics Committee of Zhejiang University.