Fifteen-year follow-up of quality of life in type 1 diabetes mellitus

Peter R van Dijk; Susan Jj Logtenberg; Klaas H Groenier; Joost C Keers; Henk Jg Bilo; Nanne Kleefstra

doi:10.4239/wjd.v5.i4.569

Fifteen-year follow-up of quality of life in type 1 diabetes mellitus

World J Diabetes. 2014 Aug 15;5(4):569-76. doi: 10.4239/wjd.v5.i4.569.

Authors

Peter R van Dijk¹, Susan Jj Logtenberg¹, Klaas H Groenier¹, Joost C Keers¹, Henk Jg Bilo¹, Nanne Kleefstra¹

Affiliation

¹ Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands.

Abstract

Aim: To evaluate metabolic control and health-related quality of life (HRQOL) in a type 1 diabetes mellitus (T1DM) population.

Methods: As part of a prospective cohort study, 283 T1DM patients treated with various insulin treatment modalities including multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII) were examined annually. HRQOL was measured using the SF-36 and EuroQol questionnaires. Data regarding HRQOL, glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed. Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.

Results: Significant changes [mean Δ (95%CI)] in body mass index [2.4 kg/m(2) (1.0, 3.8)], systolic blood pressure [-6.4 mmHg (-11.4, -1.3)] and EuroQol-VAS [-7.3 (-11.4, -3.3)] were observed over time. In 2010, 168 patients were lost to follow-up. Regarding mode of therapy, 52 patients remained on MDI, 28 remained on CSII, and 33 patients switched from MDI to CSII during follow-up. Among patients on MDI, HRQOL decreased significantly over time: mental component summary [-9.8 (-16.3, -3.2)], physical component summary [-8.6 (-15.3, -1.8)] and EuroQol-VAS [-8.1 (-14.0, -2.3)], P < 0.05 for all. For patients using CSII, the EuroQol-VAS decreased [-9.6 (-17.5, -1.7)]. None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.

Conclusion: No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.

Keywords: Continuous subcutaneous insulin infusion; Glycaemic control; Health-related quality of life; Insulin treatment; Multiple daily injections; Type 1 diabetes mellitus.