Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
J Diabetes Investig. 2021 Sep;12(9):1749-1758. doi: 10.1111/jdi.13520. Epub 2021 Mar 2.
AIMS/INTRODUCTION: To estimate preference-based measures of health-related quality of life associated with sociodemographic and clinical characteristics in type 2 diabetes patients.
Individuals with EuroQol-5 dimensions-3 levels data were identified from Taiwan's National Health Interview Survey in 2009 and 2013. Status of diabetes, comorbidities, complications and treatments were ascertained through data linkage to Taiwan's National Health Insurance Research Database. Multivariable ordinary least squares, Tobit and median regression analyses were used to estimate the coefficients that represented independent impacts of patients' characteristics on health-related quality of life.
The mean health utility score for 2,104 participants was 0.838. Being female, aging, divorced/widowed, never worked or underweight, or having a lower monthly household income, injectable glucose-lowering therapy, comorbid connective tissue disease or depression were associated with lower health utilities. Having an amputation led to the largest reduction by 0.288 in health utilities, followed by debilitating stroke (0.266), heart failure (0.237), other coronary heart disease (0.185), kidney dialysis/transplant (0.148), coronary revascularizations (0.093), transient ischemic attack/stroke (0.078), diabetic neuropathy (0.062), polyneuropathy (0.055) and other neuropathy (0.043).
Major vascular complications, connective tissue disease and depression are associated with considerably worse health-related quality of life. These health utility estimates can facilitate health economic evaluations to determine cost-effective strategies for diabetes management.
目的/引言：评估 2 型糖尿病患者社会人口学和临床特征与健康相关生活质量的偏好测量。
从 2009 年和 2013 年台湾国家健康访谈调查中确定了具有欧洲五维健康量表 3 级数据的个体。通过与台湾国家健康保险研究数据库的数据链接，确定了糖尿病、合并症、并发症和治疗的状态。多变量普通最小二乘法、Tobit 和中位数回归分析用于估计代表患者特征对健康相关生活质量的独立影响的系数。
2104 名参与者的平均健康效用得分为 0.838。女性、年龄增长、离婚/丧偶、从未工作或体重过轻、或月收入较低、注射葡萄糖降低疗法、合并结缔组织疾病或抑郁症与较低的健康效用相关。截肢导致健康效用下降最大，下降 0.288，其次是衰弱性中风（0.266）、心力衰竭（0.237）、其他冠心病（0.185）、肾透析/移植（0.148）、冠状动脉血运重建（0.093）、短暂性脑缺血发作/中风（0.078）、糖尿病神经病变（0.062）、多发性神经病（0.055）和其他神经病（0.043）。
主要血管并发症、结缔组织疾病和抑郁症与健康相关生活质量明显恶化相关。这些健康效用估计可以促进健康经济学评估，以确定具有成本效益的糖尿病管理策略。
