Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
AstraZeneca, Gaithersburg, MD, USA.
Diabetes Res Clin Pract. 2021 Oct;180:108974. doi: 10.1016/j.diabres.2021.108974. Epub 2021 Jul 22.
To investigate factors associated with health-related quality of life (HRQoL) in patients with type 2 diabetes mellitus (T2D) at initiation of second-line glucose-lowering therapy.
DISCOVER is a 3-year, prospective observational study of patients with T2D initiating second-line glucose-lowering therapy, conducted in 38 countries. HRQoL at baseline was assessed using the physical and mental component summary (PCS; MCS) scores of the 36-Item Short Form Health Survey version 2 (SF-36v2) in 31 countries (n = 8309) and the Hypoglycaemia Fear Survey-II (HFS-II) in 23 countries (n = 6516). Factors associated with differences in HRQoL were assessed using multivariable hierarchical regression models.
Mean PCS and MCS scores were 48.0 (standard deviation [SD]: 7.8) and 45.5 (SD: 10.4), respectively. Factors associated with significantly lower SF-36v2 scores included being female, having a history of macrovascular complications and first-line treatment with oral combinations (vs metformin monotherapy). Mean HFS-II behaviour and worry scores were 8.2 (SD: 9.9) and 7.3 (SD: 11.8), respectively. Increased fear of hypoglycaemia was significantly associated with lower SF-36v2 scores.
Several patient-, disease- and treatment-related characteristics correlated with HRQoL, indicating that a multifactorial approach is needed to maintain HRQoL in patients with T2D.
调查起始二线降糖治疗的 2 型糖尿病(T2D)患者健康相关生活质量(HRQoL)的相关因素。
DISCOVER 是一项为期 3 年、前瞻性观察性研究,纳入了起始二线降糖治疗的 T2D 患者,在 38 个国家开展。使用健康调查简表 36 项(SF-36v2)的生理和心理成分综合评分(PCS;MCS)评估基线时的 HRQoL,该量表在 31 个国家(n=8309)开展,在 23 个国家(n=6516)开展低血糖恐惧调查量表-修订版(HFS-II)。使用多变量分层回归模型评估与 HRQoL 差异相关的因素。
平均 PCS 和 MCS 评分为 48.0(标准差 [SD]:7.8)和 45.5(SD:10.4)。与 SF-36v2 评分显著降低相关的因素包括女性、有大血管并发症史和一线治疗采用口服联合药物(vs 二甲双胍单药治疗)。平均 HFS-II 行为和担忧评分分别为 8.2(SD:9.9)和 7.3(SD:11.8)。低血糖恐惧增加与 SF-36v2 评分降低显著相关。
一些患者、疾病和治疗相关特征与 HRQoL 相关,表明需要采取多因素方法来维持 T2D 患者的 HRQoL。