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Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes - A nationwide cross-sectional study

Svedbo Engström, Maria; Leksell, Janeth; Johansson, Unn Britt; Borg, Sixten LU ; Palaszewski, Bo; Franzén, Stefan; Gudbjörnsdottir, Soffia and Eeg-Olofsson, Katarina (2019) In Health and Quality of Life Outcomes 17(1).
Abstract

Background: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting. Methods: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18-80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36-item Short Form version 2 (SF-36v2) was answered by 1373... (More)

Background: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting. Methods: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18-80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36-item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes. Results: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures. Conclusions: Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cross-sectional study, Diabetes mellitus, type 1, Diabetes mellitus, type 2, Health-related quality of life, SF-36
in
Health and Quality of Life Outcomes
volume
17
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85071014854
ISSN
1477-7525
DOI
10.1186/s12955-019-1212-z
language
English
LU publication?
yes
id
afcdd17a-4ede-4429-b740-b39e4f766d62
date added to LUP
2019-09-24 14:51:32
date last changed
2019-09-26 04:44:41
@article{afcdd17a-4ede-4429-b740-b39e4f766d62,
  abstract     = {<p>Background: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting. Methods: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18-80 years with at least one registered test of glycated haemoglobin (HbA<sub>1c</sub>) the last 12 months. The generic 36-item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes. Results: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA<sub>1c</sub>, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (&lt; 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures. Conclusions: Among people with type 1 and type 2 diabetes, adults with high-risk HbA<sub>1c</sub> levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA<sub>1c</sub> levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.</p>},
  articleno    = {141},
  author       = {Svedbo Engström, Maria and Leksell, Janeth and Johansson, Unn Britt and Borg, Sixten and Palaszewski, Bo and Franzén, Stefan and Gudbjörnsdottir, Soffia and Eeg-Olofsson, Katarina},
  issn         = {1477-7525},
  keyword      = {Cross-sectional study,Diabetes mellitus, type 1,Diabetes mellitus, type 2,Health-related quality of life,SF-36},
  language     = {eng},
  month        = {08},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Health and Quality of Life Outcomes},
  title        = {Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes - A nationwide cross-sectional study},
  url          = {http://dx.doi.org/10.1186/s12955-019-1212-z},
  volume       = {17},
  year         = {2019},
}