Published norms underestimate the health-related quality of life among persons with type 2 diabetes

J Clin Epidemiol. 2011 Apr;64(4):358-65. doi: 10.1016/j.jclinepi.2010.04.016. Epub 2010 Aug 30.


Objective: To assess health-related quality of life (HRQL) among adults with type 2 diabetes using the Short Form (SF)-36 and to obtain pooled estimates of HRQL for subpopulations defined by demographic characteristics, diabetes-related complications, and comorbidities.

Study design and methods: We conducted computerized searches of multiple electronic bibliographic databases, and studies in any language were selected in which HRQL was reported among adults with type 2 diabetes using the SF-36. Estimates were combined using a random-effects model.

Results: One hundred eighteen studies fulfilled the inclusion criteria. HRQL was lower in persons with type 2 diabetes, as measured by all the eight component scores of the SF-36 when compared with the existing U.S. population norms and with previously published type 2 diabetes norms. SF-36 component and summary scores were extremely heterogeneous, and subpopulation data were sparse; this precluded obtaining meaningful pooled scores for most populations of interest and made comparisons among subpopulations difficult.

Conclusion: Our data suggest that previously published norms may underestimate the effect of diabetes on HRQL, and diabetes populations are extremely heterogeneous, making broad population "norms" for HRQL in type 2 diabetes of limited use. Additional research with important subpopulations and individual-level data are needed to further explore the effect of diabetes on HRQL.

Publication types

  • Review

MeSH terms

  • Databases, Bibliographic
  • Diabetes Mellitus, Type 2*
  • Evidence-Based Medicine
  • Female
  • Health Status*
  • Humans
  • Male
  • Outcome Assessment, Health Care / standards*
  • Quality of Life*
  • Sickness Impact Profile
  • Surveys and Questionnaires