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Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy

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Abstract

Purpose

To investigate a 10-year change of quality of life and associated factors in a population with type 1 diabetes.

Methods

The Medical Outcome Study Short Form-36 (SF-36) was administered in participants (n = 520) at the 1995–1996 and 2005–2007 examination phases of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Physical (PCS) and mental (MCS) component summary scores were calculated. The associations between changes of quality of life and demographic, socioeconomic, and clinical factors were analyzed.

Results

PCS score decreased (p < 0.001) and MCS score increased (p < 0.001) after 10 years. The development of cardiovascular disease and the presence of limb amputation were associated with decrease in the PCS score. Those who were working and retired had increased MCS; those who were working and stopped had a decrease in the MCS score. Change in visual acuity and diabetic retinopathy status did not have a significant impact in health-related quality of life scores.

Conclusions

Our findings reinforce the necessity to make every attempt to decrease complications of diabetes in individuals with long-term type 1 diabetes in order to attenuate the diminished quality of life associated with those complications such as cardiovascular disease. Change in employment status, likely due to development of these complications, was also strongly associated with poorer quality of life and suggests the benefits of preventing or decreasing complications to keep people with type 1 diabetes in the workforce.

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References

  1. Rubin, R. R., & Peyrot, M. (1999). Quality of life and diabetes. Diabetes Metab Res Rev, 15(3), 205–218.

    Article  PubMed  CAS  Google Scholar 

  2. Hart, H. E., Bilo, H. J., Redekop, W. K., Stolk, R. P., Assink, J. H., & Meyboom-de, J. B. (2003). Quality of life of patients with type I diabetes mellitus. Quality of Life Research, 12(8), 1089–1097.

    Article  PubMed  CAS  Google Scholar 

  3. Matza, L. S., Rousculp, M. D., Malley, K., Boye, K. S., & Oglesby, A. (2008). The longitudinal link between visual acuity and health-related quality of life in patients with diabetic retinopathy. Health Qual Life Outcomes, 6, 95.

    Article  PubMed  Google Scholar 

  4. Hart, H. E., Redekop, W. K., Berg, M., Bilo, H. J., & Meyboom-de, J. B. (2005). Factors that predicted change in health-related quality of life were identified in a cohort of diabetes mellitus type 1 patients. Journal of Clinical Epidemiology, 58(11), 1158–1164.

    Article  PubMed  Google Scholar 

  5. Jacobson, A. M. (1997). Quality of Life in Patients With Diabetes Mellitus. Semin Clin Neuropsychiatry, 2(1), 82–93.

    PubMed  Google Scholar 

  6. Hahl, J., Hamalainen, H., Sintonen, H., Simell, T., Arinen, S., & Simell, O. (2002). Health-related quality of life in type 1 diabetes without or with symptoms of long-term complications. Quality of Life Research, 11(5), 427–436.

    Article  PubMed  CAS  Google Scholar 

  7. Wandell, P. E., Brorsson, B., & Aberg, H. (1998). Quality of life among diabetic patients in Swedish primary health care and in the general population: comparison between 1992 and 1995. Quality of Life Research, 7(8), 751–760.

    Article  PubMed  CAS  Google Scholar 

  8. Huang, G. H., Palta, M., Allen, C., LeCaire, T., & D’Alessio, D. (2004). Self-rated health among young people with type 1 diabetes in relation to risk factors in a longitudinal study. American Journal of Epidemiology, 159(4), 364–372.

    Article  PubMed  Google Scholar 

  9. Klein, R., Klein, B. E., Moss, S. E., DeMets, D. L., Kaufman, I., & Voss, P. S. (1984). Prevalence of diabetes mellitus in southern Wisconsin. American Journal of Epidemiology, 119(1), 54–61.

    PubMed  CAS  Google Scholar 

  10. Klein, R., Klein, B. E., Moss, S. E., Davis, M. D., & DeMets, D. L. (1984). The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Archives of Ophthalmology, 102(4), 520–526.

    Article  PubMed  CAS  Google Scholar 

  11. Klein, R., Klein, B. E., Moss, S. E., Davis, M. D., & DeMets, D. L. (1989). The Wisconsin Epidemiologic Study of Diabetic Retinopathy. IX. Four-year incidence and progression of diabetic retinopathy when age at diagnosis is less than 30 years. Archives of Ophthalmology, 107(2), 237–243.

    Article  PubMed  CAS  Google Scholar 

  12. Klein, R., Klein, B. E., Moss, S. E., & Cruickshanks, K. J. (1994). The Wisconsin Epidemiologic Study of diabetic retinopathy. XIV. Ten-year incidence and progression of diabetic retinopathy. Archives of Ophthalmology, 112(9), 1217–1228.

    Article  PubMed  CAS  Google Scholar 

  13. Klein, R., Klein, B. E., Moss, S. E., & Cruickshanks, K. J. (1998). The Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology, 105(10), 1801–1815.

    Article  PubMed  CAS  Google Scholar 

  14. Klein, B. E., Klein, R., McBride, P. E., et al. (2004). Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes: Wisconsin epidemiologic study of diabetic retinopathy. Archives of Internal Medicine, 164(17), 1917–1924.

    Article  PubMed  Google Scholar 

  15. The Early Treatment Diabetic Retinopathy Study Group. In: ETDRS Coordinating Center, ed. Early Treatment Diabetic Retinopathy Study: Manual of Operations: Department of Epidemiology and Preventive Medicine University of Maryland Baltimore; 1985.

  16. Quick Step. (1981). Fast Hemoglobin Test System. 1-8.

  17. Ware, J. E., Kosinski, M., & Gandek, B. (1993). SF-36 Health survey: manual & interpretation guide. Lincoln, RI: QualityMetric Incorporated.

    Google Scholar 

  18. Ware J. E. Scoring Algorithms. In: Ware JE, Kosinski MA, Keller SD, eds. SF-36 Physical and Mental Health Summary Scales: A User’s Manual. Boston: The Health Institute, New England Medical Center; 1994.

  19. Early Treatment Diabetic Retinopathy Study Research Group. (1991). Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12.. Ophthalmology, 98(5 Suppl), 823-833.

  20. Early Treatment Diabetic Retinopathy Study Research Group. (1991). Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7. Ophthalmology, 98(5 Suppl), 741-756.

  21. Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003). Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Medical Care, 41(5), 582–592.

    PubMed  Google Scholar 

  22. Allison, P. D. (1990). Change scores as dependent variables in regression analysis. Sociological Methodology, 20, 93–114.

    Article  Google Scholar 

  23. Wikblad, K., Leksell, J., & Wibell, L. (1996). Health-related quality of life in relation to metabolic control and late complications in patients with insulin dependent diabetes mellitus. Quality of Life Research, 5(1), 123–130.

    Article  PubMed  CAS  Google Scholar 

  24. Aalto, A. M., Uutela, A., & Aro, A. R. (1997). Health related quality of life among insulin-dependent diabetics: disease-related and psychosocial correlates. Patient Education and Counseling, 30(3), 215–225.

    Article  PubMed  CAS  Google Scholar 

  25. Clarke, P. M., Simon, J., Cull, C. A., & Holman, R. R. (2006). Assessing the impact of visual acuity on quality of life in individuals with type 2 diabetes using the short form-36. Diabetes Care, 29(7), 1506–1511.

    Article  PubMed  Google Scholar 

  26. Hariprasad, S. M., Mieler, W. F., Grassi, M., Green, J. L., Jager, R. D., & Miller, L. (2008). Vision-related quality of life in patients with diabetic macular oedema. British Journal of Ophthalmology, 92(1), 89–92.

    Article  PubMed  CAS  Google Scholar 

  27. Brown, M. M., Brown, G. C., Sharma, S., Landy, J., & Bakal, J. (2002). Quality of life with visual acuity loss from diabetic retinopathy and age-related macular degeneration. Archives of Ophthalmology, 120(4), 481–484.

    Article  PubMed  Google Scholar 

  28. Wikby, A., Hornquist, J. O., Stenstrom, U., & Andersson, P. O. (1993). Background factors, long-term complications, quality of life and metabolic control in insulin dependent diabetes. Quality of Life Research, 2(4), 281–286.

    Article  PubMed  CAS  Google Scholar 

  29. The Diabetes Control and Complications Trial Research Group. (1996). Influence of intensive diabetes treatment on quality-of-life outcomes in the Diabetes Control and Complications Trial. Diabetes Care, 19(3), 195–203.

    Article  Google Scholar 

  30. Judge, T. A., & Bono, J. E. (2001). Relationship of core self-evaluations traits–self-esteem, generalized self-efficacy, locus of control, and emotional stability–with job satisfaction and job performance: a meta-analysis. Journal of Applied Psychology, 86(1), 80–92.

    Article  PubMed  CAS  Google Scholar 

  31. Shih, M., & Simon, P. A. (2008). Health-related quality of life among adults with serious psychological distress and chronic medical conditions. Quality of Life Research, 17(4), 521–528.

    Article  PubMed  Google Scholar 

  32. Glasgow, R. E., Ruggiero, L., Eakin, E. G., Dryfoos, J., & Chobanian, L. (1997). Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care, 20(4), 562–567.

    Article  PubMed  CAS  Google Scholar 

  33. Hanestad, B. R. (1993). Self-reported quality of life and the effect of different clinical and demographic characteristics in people with type 1 diabetes. Diabetes Research and Clinical Practice, 19(2), 139–149.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The study was supported by the National Institutes of Health (Bethesda, MD) Grant No. EY06594 and EY016379 (R Klein, BEK Klein) and, in part, by Research to Prevent Blindness (R. Klein and BEK Klein, Senior Scientific Investigator Awards), New York (NY). The National Eye Institute provided funding for entire study including collection and analyses of data; RPB provided further additional support for data analyses. This research was also supported by the Mentor-based Post-doctoral Fellowship Award from the American Diabetes Association, Alexandria, VA (to R.K.).

Conflict of interest

The authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Flavio E. Hirai

  2. Department of Ophthalmology, Federal University of Sao Paulo, Rua Botucatu, 820, Sao Paulo, Brazil

    Flavio E. Hirai

  3. Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    James M. Tielsch

  4. Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA

    Barbara E. K. Klein & Ronald Klein

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  1. Flavio E. Hirai
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  2. James M. Tielsch
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  3. Barbara E. K. Klein
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  4. Ronald Klein
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Correspondence to Flavio E. Hirai.

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Hirai, F.E., Tielsch, J.M., Klein, B.E.K. et al. Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy. Qual Life Res 22, 1245–1253 (2013). https://doi.org/10.1007/s11136-012-0245-0

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