PDB68 - Complications Related Health Utility Decrements for Type 2 Diabetes Population in the United States

Abstract

The study aimed to develop a complete equation to examine health utility decrements associated with current and history of the complications among type 2 diabetes patients. Health Utilities Index Mark 3 (HUI3) (range: 0~1) was used to measure the quality of life in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Five macrovascular complications (myocardial infarction (MI), congestive heart failure (CHF), stroke, angina, and revascularization surgery (RS)) and twelve microvascular complications (nephropathy (4 levels), retinopathy (4 levels) and neuropathy (4 levels)) were included in this study. Both ordinary least squares (OLS) model and fixed effect model were applied to estimate the complication-related decrements on health utility scores, adjusting for demographic characteristics. Age at diagnosis (-0.002 per year), female sex (-0.043), education below college (-0.051), current smoker (-0.054), high BMI (-0.007 per unit) and longer diabetes duration (-0.005 per year) were associated with lower quality of life, and compared to blacks, Hispanics (-0.044) or whites (-0.019) were also associated with lower quality of life (all p<0.05). All macrovascular complications had statistically significant impact (i.e., p<0.05) on health utility scores: MI (event year: -0.043, successive years: -0.011), CHF (event year: -0.092, successive years: -0.041), stroke (event year: -0.203, successive years: -0.102), angina (event year: -0.011, successive years: -0.032), revascularization (event year: -0.038, successive years: -0.016). For those 12 included microvascular complications, only renal failure (-0.026), severe vision loss (-0.058), and severe pressure sensation loss (-0.067) were found to be significantly associated with lower health utility Macrovascular and microvascular complications were associated with patients’ quality of life. A complete health utility equation from the ACCORD study could help researchers to improve cost-effectiveness study.