Changes in quality of life associated with complications of diabetes

Results from the ADVANCE study

Alison Hayes, Hisatomi Arima, Mark Woodward, John Chalmers, Neil Poulter, Pavel Hamet, Philip Clarke

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)36-41
Number of pages6
JournalValue in Health
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Diabetes Complications
Quality of Life
perindopril drug combination indapamide
Blindness
Amputation
Renal Insufficiency
Myocardial Ischemia
Heart Failure
Stroke
Myocardial Infarction
Gliclazide
Economic Models
Health
Vascular Diseases
Type 2 Diabetes Mellitus
Economics
Confidence Intervals
Surveys and Questionnaires

Keywords

  • complications
  • longitudinal analysis
  • quality of life
  • type 2 diabetes

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Hayes, A., Arima, H., Woodward, M., Chalmers, J., Poulter, N., Hamet, P., & Clarke, P. (2016). Changes in quality of life associated with complications of diabetes: Results from the ADVANCE study. Value in Health, 19(1), 36-41. https://doi.org/10.1016/j.jval.2015.10.010

Changes in quality of life associated with complications of diabetes : Results from the ADVANCE study. / Hayes, Alison; Arima, Hisatomi; Woodward, Mark; Chalmers, John; Poulter, Neil; Hamet, Pavel; Clarke, Philip.

In: Value in Health, Vol. 19, No. 1, 01.01.2016, p. 36-41.

Research output: Contribution to journalArticle

Hayes, A, Arima, H, Woodward, M, Chalmers, J, Poulter, N, Hamet, P & Clarke, P 2016, 'Changes in quality of life associated with complications of diabetes: Results from the ADVANCE study', Value in Health, vol. 19, no. 1, pp. 36-41. https://doi.org/10.1016/j.jval.2015.10.010
Hayes, Alison ; Arima, Hisatomi ; Woodward, Mark ; Chalmers, John ; Poulter, Neil ; Hamet, Pavel ; Clarke, Philip. / Changes in quality of life associated with complications of diabetes : Results from the ADVANCE study. In: Value in Health. 2016 ; Vol. 19, No. 1. pp. 36-41.
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