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Health-related quality of life in diabetes: The associations of complications with EQ-5D scores

Oddvar Solli1*, Knut Stavem2,3 and IS Kristiansen1,4

Author Affiliations

1 Institute of Health Management and Health Economics, P.O. Box 1089 Blindern, N-0317 Oslo, Norway

2 Health Services Research Centre, Akershus University Hospital, N-1478 Lørenskog, Norway

3 Faculty of Medicine, University of Oslo, NO-0316 Oslo, Norway

4 Institute of Public Health, University of Southern Denmark, DK-5000 Odense, Denmark

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Health and Quality of Life Outcomes 2010, 8:18 doi:10.1186/1477-7525-8-18

Published: 4 February 2010

Abstract

Background

The aim of this study was to describe how diabetes complications influence the health-related quality of life of individuals with diabetes using the individual EQ-5D dimensions and the EQ-5D index.

Methods

We mailed a questionnaire to 1,000 individuals with diabetes type 1 and 2 in Norway. The questionnaire had questions about socio-demographic characteristics, use of health care, diabetes complications and finally the EQ-5D descriptive system. Logistic regressions were used to explore determinants of responses in the EQ-5D dimensions, and robust linear regression was used to explore determinants of the EQ-5D index.

Results

In multivariate analyses the strongest determinants of reduced MOBILITY were neuropathy and ischemic heart disease. In the ANXIETY/DEPRESSION dimension of the EQ-5D, "fear of hypoglycaemia" was a strong determinant. For those without complications, the EQ-5D index was 0.90 (type 1 diabetes) and 0.85 (type 2 diabetes). For those with complications, the EQ-5D index was 0.68 (type 1 diabetes) and 0.73 (type 2 diabetes). In the linear regression the factors with the greatest negative impact on the EQ-5D index were ischemic heart disease (type 1 diabetes), stroke (both diabetes types), neuropathy (both diabetes types), and fear of hypoglycaemia (type 2 diabetes).

Conclusions

The EQ-5D dimensions and the EQ-5D seem capable of capturing the consequences of diabetes-related complications, and such complications may have substantial impact on several dimensions of health-related quality of life (HRQoL). The strongest determinants of reduced HRQoL in people with diabetes were ischemic heart disease, stroke and neuropathy.