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

Abstract

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. 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). 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. 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.