Health-related quality of life, disease severity, and anticipated trajectory of diabetes

Diabetes Educ. 2013 Jan-Feb;39(1):83-91. doi: 10.1177/0145721712467697. Epub 2012 Nov 21.


Purpose: Adults hospitalized with diabetes are likely to have multiple comorbid conditions contributing to suboptimal health-related quality of life. The purpose of this study was to survey urban, very low-income, hospitalized adults with diabetes about disease severity, anticipated disease trajectory, and self-rated health-related quality of life.

Methods: Data were collected using the Brief Illness Perception Questionnaire, the 36-item Short Form Health Survey (SF-36), the comparative risk perception questionnaire, and glycosylated hemoglobin. Severity was defined by glycosylated hemoglobin level and current microvascular complications from diabetes.

Findings: Those with more severe disease who also anticipated the development of additional diabetes-related complications were likely to have suboptimal physical and mental functioning. The perception of diabetes as a health threat concurrent with having non-diabetes-related comorbid chronic conditions contributed uniquely to explaining scores in health-related quality of life.

Conclusion: Hospitalized adults with diabetes represent a population affected by chronic disease demands that contribute to suboptimal physical and mental functioning. Suboptimal quality of life may contribute to severity of diabetes and to a perception of having a threatening disease trajectory. Hospitalization provides an opportunity for clinicians to intervene in mental and physical functioning by assessing for threatening illness perceptions and employing interventions to promote acceptance of functional limitations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism*
  • Chronic Disease
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Educational Status
  • Female
  • Glycated Hemoglobin A / metabolism*
  • Health Status
  • Hospitalization
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Quality of Life*
  • Social Class
  • Surveys and Questionnaires
  • United States / epidemiology
  • Urban Population / statistics & numerical data


  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human