Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Qual Life Res. 2013 Aug;22(6):1245-53. doi: 10.1007/s11136-012-0245-0. Epub 2012 Aug 8.
To investigate a 10-year change of quality of life and associated factors in a population with type 1 diabetes.
The Medical Outcome Study Short Form-36 (SF-36) was administered in participants (n = 520) at the 1995-1996 and 2005-2007 examination phases of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Physical (PCS) and mental (MCS) component summary scores were calculated. The associations between changes of quality of life and demographic, socioeconomic, and clinical factors were analyzed.
PCS score decreased (p < 0.001) and MCS score increased (p < 0.001) after 10 years. The development of cardiovascular disease and the presence of limb amputation were associated with decrease in the PCS score. Those who were working and retired had increased MCS; those who were working and stopped had a decrease in the MCS score. Change in visual acuity and diabetic retinopathy status did not have a significant impact in health-related quality of life scores.
Our findings reinforce the necessity to make every attempt to decrease complications of diabetes in individuals with long-term type 1 diabetes in order to attenuate the diminished quality of life associated with those complications such as cardiovascular disease. Change in employment status, likely due to development of these complications, was also strongly associated with poorer quality of life and suggests the benefits of preventing or decreasing complications to keep people with type 1 diabetes in the workforce.
调查 1 型糖尿病患者的生活质量及其相关因素在 10 年内的变化。
在威斯康星州糖尿病视网膜病变流行病学研究(WESDR)的 1995-1996 年和 2005-2007 年检查阶段,对参与者(n=520)进行了医疗结果研究简表 36 项(SF-36)的评估。计算了生理(PCS)和心理(MCS)综合评分。分析了生活质量变化与人口统计学、社会经济和临床因素之间的关系。
10 年后,PCS 评分下降(p<0.001),MCS 评分上升(p<0.001)。心血管疾病的发展和肢体截肢与 PCS 评分下降有关。工作和退休的人 MCS 增加;工作和停止工作的人 MCS 评分下降。视力变化和糖尿病视网膜病变状况对健康相关生活质量评分没有显著影响。
我们的研究结果强化了尽一切努力减少长期 1 型糖尿病患者并发症的必要性,以减轻与心血管疾病等并发症相关的生活质量下降。就业状况的变化,可能是由于这些并发症的发展,也与较差的生活质量密切相关,这表明预防或减少并发症对保持 1 型糖尿病患者的工作能力的益处。