Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan;19(1):36-41.
doi: 10.1016/j.jval.2015.10.010. Epub 2015 Dec 2.

Changes in Quality of Life Associated with Complications of Diabetes: Results from the ADVANCE Study

Alison Hayes  1 , Hisatomi Arima  2 , Mark Woodward  3 , John Chalmers  4 , Neil Poulter  5 , Pavel Hamet  6 , Philip Clarke  7
Affiliations
Free article

Changes in Quality of Life Associated with Complications of Diabetes: Results from the ADVANCE Study

Alison Hayes et al. Value Health. 2016 Jan.
Free article

Abstract

Objective: To measure the impact of complications on summary measures of health-related quality of life among people with type 2 diabetes.

Methods: Patients participating in the Action in Diabetes and Vascular Disease:Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial were administered a health-related quality-of-life questionnaire, the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L), on four occasions over a 5-year period. We used two-way fixed-effects longitudinal regression models to investigate the impact of incident diabetes complications (stroke, heart failure, myocardial infarction, ischemic heart disease, renal failure, blindness, and amputation) on EQ-5D-3L utility score (where 1 = perfect health), while controlling for characteristics of individuals that do not vary over time.

Results: The effect of having any one of the seven complications was to reduce the EQ-5D-3L utility score by 0.054 (95% confidence interval 0.044-0.064), and this was not significantly affected by baseline age, sex, economic region, or the value set used to derive utilities. The complication with the largest disutility was amputation (0.122), followed by stroke (0.099), blindness (0.083), renal failure (0.049), heart failure (0.045), and myocardial infarction (0.026). Ischemic heart disease did not significantly reduce the utility score. Quality of life also declined with elapsed time-by an average of 0.006 per year, in addition to the effect of complications.

Conclusions: Common complications significantly reduce health-related quality of life. Utility scores derived from the EQ-5D-3L provide a potential measure that can be used to summarize patient-reported outcomes and inform health economic models. Prevention of complications is critical to reduce the progressive burden of declining quality of life for people with diabetes.

Trial registration: ClinicalTrials.gov NCT00145925.

Keywords: complications; longitudinal analysis; quality of life; type 2 diabetes.

PubMed Disclaimer

Publication types

Associated data