Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: findings from Australia’s living with diabetes cohort study

Health and Quality of Life Outcomes

Suhail AR Doi¹  Bryan Mukandi¹  Peter Baker¹  Joseph R Coll¹  Jo Dower¹  Maria Donald¹ 

[1] School of Population Health, University of Queensland, Herston Campus, Brisbane, Queensland, Australia

关键词: Adults;    Type 2 diabetes;    Audit of Diabetes-Dependent Quality of Life (ADDQoL);    Diabetes-specific quality of life;   

Others  :  822336
DOI  :  10.1186/1477-7525-11-170

 received in 2013-05-24, accepted in 2013-10-11,  发布年份 2013

【 摘 要 】

Background

While factors associated with health-related quality of life for people with chronic diseases including diabetes are well researched, far fewer studies have investigated measures of disease-specific quality of life. The purpose of this study is to assess the impact of complications and comorbidities on diabetes-specific quality of life in a large population-based cohort of type 2 diabetic patients.

Methods

The Living with Diabetes Study recruited participants from the National Diabetes Services Scheme in Australia. Data were collected via a mailed self-report questionnaire. Diabetes-specific quality of life was measured using the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire. The analyses are for 3609 patients with type 2 diabetes. Regression models with adjustment for control variables investigated the association of complications and comorbidities with diabetes-specific quality of life. Next, the most parsimonious model for diabetes-specific quality of life after controlling for important covariates was examined.

Results

The expected associations with better diabetes-specific quality of life were evident, such as increased income, not on insulin, better glycaemic control and older age. However, being single and having been diagnosed with cancer were also associated with better ADDQoL. Additionally, poorer diabetes-specific quality of life was strongly sensitive to the presence of diabetes complications and mental health conditions such as depression, anxiety and schizophrenia. These relationships persisted after adjustment for gender, age, duration of diabetes, treatment regimen, sampling region and other treatment and socio-demographic variables.

Conclusions

A greater appreciation of the complexities of diabetes-specific quality of life can help tailor disease management and self-care messages given to patients. Attention to mental health issues may be as important as focusing on glycaemic control and complications. Therefore clinicians’ ability to identify and mange mental health issues and/or refer patients is critical to improving patients’ diabetes-specific quality of life.

【 授权许可】

   
2013 Donald et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Shaw JE, Sicree RA, Zimmet PZ: Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010, 87:4-14.
• [2]Ali S, Stone M, Skinner TC, Robertson N, Davies M, Khunti K: The association between depression and health-related quality of life in people with type 2 diabetes: a systematic literature review. Diabetes Metab Res Rev 2010, 26:75-89.
• [3]Rubin RR, Peyrot M: Quality of life and diabetes. Diabetes Metab Res Rev 1999, 15:205-218.
• [4]Bradley C: Importance of differentiating health status from quality of life. Lancet 2001, 357:7-8.
• [5]Sundaram M, Kavookjian J, Patrick JH: Health-related quality of life and quality of life in type 2 diabetes: relationships in a cross-sectional study. The Patient: Patient-Centered Outcomes Research 2009, 2:121-133.
• [6]Magwood GS, Zapka J, Jenkins C: A review of systematic reviews evaluating diabetes interventions - focus on quality of life and disparities. Diabetes Educ 2008, 34:242-265.
• [7]El Achhab Y, Nejjari C, Chikri M, Lyoussi B: Disease-specific health-related quality of life instruments among adults diabetic: a systematic review. Diabetes Res Clin Pract 2008, 80:171-184.
• [8]Garratt AM, Schmidt L, Fitzpatrick R: Patient-assessed health outcome measures for diabetes: a structured review. Diabet Med 2002, 19:1-11.
• [9]Bradley C, Todd C, Gorton T, Symonds E, Martin A, Plowright R: The development of an individualised questionnaire measure of perceived impact of diabetes on quality of life: the ADDQoL. Qual Life Res 1999, 8:79-91.
• [10]Bradley C, Speight J: Patient perceptions of diabetes and diabetes therapy: assessing quality of life. Diabetes Metab Res Rev 2002, 18:S64-S69.
• [11]Soon SS, Goh SY, Bee YM, Poon JL, Li SC, Thumboo J, Wee HL: Audit of Diabetes-Dependent Quality of Life (ADDQoL) [Chinese version for Singapore] questionnaire: reliability and validity among Singaporeans with type 2 diabetes mellitus. Appl Health Econ Health Policy 2010, 8:239-249.
• [12]Wee H, Tan C, Goh S, Li S: Usefulness of the Audit of Diabetes-Dependent Quality-of-Life (ADDQoL) Questionnaire in patients with diabetes in a multi-ethnic asian country. Pharmacoeconomics 2006, 24:673-682.
• [13]Da Costa FA, Guerreiro JP, Duggan C: An Audit of Diabetes Dependent Quality of Life (ADDQoL) for Portugal: exploring validity and reliability. Pharm Pract 2006, 4:123-128.
• [14]Woodcock AJ, Julious SA, Kinmonth AL, Campbell MJ: Problems with the performance of the SF-36 among people with type 2 diabetes in general practice. Qual Life Res 2001, 10:661-670.
• [15]Donald M, Dower J, Ware R, Mukandi B, Parehk S, Bain C: Living with diabetes: rationale, study design and baseline characteristics for an Australian prospective cohort study. BMC Public Health 2012, 12:8. BioMed Central Full Text
• [16]David M, Ware R, Donald M, Alati R: Assessing generalisability through the use of disease registers: findings from a diabetes cohort study. BMJ Open 2011, 1:e000078. doi:10.1136/bmjopen-2011-000078
• [17]AIHW: Diabetes prevalence in Australia: an assessment of national data sources. Canberra: Australian Institute of Health and Welfare; 2009.
• [18]Speight J, Reaney MD, Barnard KD: Not all roads lead to Rome - a review of quality of life measurement in adults with diabetes. Diabet Med 2009, 26:315-327.
• [19]Ostini R, Dower J, Donald M: The Audit of Diabetes Dependent Quality of Life 19 (ADDQoL): feasibility, reliability and validity in a population based sample of Australian adults. Qual Life Res 2011, 21(8):1471-7.
• [20]Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG: Weight management through lifestyle modification for the prevention and management of type 2 diabetes: Rationale and strategies. Diabetes Care 2004, 27:2067-2073.
• [21]Pan X-R, Li G-W, Hu Y-H, Wang J-X, Yang W-Y, An Z-X, Hu Z-X, Juan-Lin , Xiao J-Z, Cao H-B, et al.: Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and diabetes study. Diabetes Care 1997, 20:537-544.
• [22]Paddison C, Alpass F, Stephens C: Psychological factors account for variation in metabolic control and perceived quality of life among people with type 2 diabetes in New Zealand. Int J Behav Med 2008, 15:180-186.
• [23]Verma SK, Luo N, Subramaniam M, Sum CF, Stahl D, Liow PH, Chong SA: Impact of depression on health related quality of life in patients with diabetes. Ann Acad Med Singapore 2010, 39:913-919.
• [24]Egede LE, Ellis C, Grubaugh AL: The effect of depression on self-care behaviors and quality of care in a national sample of adults with diabetes. Gen Hosp Psychiatry 2009, 31:422-427.
• [25]Lee H-J, Chapa D, Kao C-W, Jones D, Kapustin J, Smith J, Krichten C, Donner T, Thomas SA, Friedmann E: Depression, quality of life, and glycemic control in individuals with type 2 diabetes. J Am Acad Nurse Pract 2009, 21:214-224.
• [26]Lewko J, Zarzycki W, Krajewska-Kulak E: Relationship between the occurrence of symptoms of anxiety and depression, quality of life, and level of acceptance of illness in patients with type 2 diabetes. Saudi Med J 2012, 33:887-894.
• [27]Schram MT, Baan CA, Pouwer F: Depression and quality of life in patients with diabetes: a systematic review from the European Depression in Diabetes (EDID) research consortium. Curr Diabetes Rev 2009, 5:112-119.
• [28]Bowker S, Pohar S, Johnson J: A cross-sectional study of health-related quality of life deficits in individuals with comorbid diabetes and cancer. Health Qual Life Outcomes 2006, 4:17. BioMed Central Full Text
• [29]Papelbaum M, Lemos HM, Duchesne M, Kupfer R, Moreira RO, Coutinho WF: The association between quality of life, depressive symptoms and glycemic control in a group of type 2 diabetes patients. Diabetes Res Clin Pract 2010, 89:227-230.
• [30]Rubin RR, Ciechanowski P, Egede LE, Lin EH, Lustman PJ: Recognizing and treating depression in patients with diabetes. Curr Diab Rep 2004, 4:119-125.
• [31]Fugl-Meyer AR, Melin R, Fugl-Meyer KS: Life satisfaction in 18- to 64-year-old Swedes: in relation to gender, age, partner and immigrant status. J Rehabilitation Med (Taylor & Francis Ltd) 2002, 34:239-246.
• [32]Atlantis E, Goldney R, Eckert K, Taylor A, Phillips P: Trends in health-related quality of life and health service use associated with comorbid diabetes and major depression in South Australia, 1998–2008. Soc Psychiatry Psychiatr Epidemiol 2012, 47:871-877.
• [33]Nohr EA, Frydenberg M, Henriksen TB, Olsen J: Does low participation in cohort studies induce bias? Epidemiology 2006, 17:413-418.