TY - JOUR
T1 - The longitudinal association between glycaemic control and health-related quality of life following insulin therapy optimisation in type 2 diabetes patients. A prospective observational study in secondary care
AU - Hajós, T.R.S.
AU - Pouwer, F.
AU - de Grooth, R.
AU - Holleman, F.
AU - Twisk, J.W.R.
AU - Diamant, M.
AU - Snoek, F.J.
PY - 2012
Y1 - 2012
N2 - Purpose To test whether improvement in glycosylated haemoglobin (HbA(1c)) as a marker of glycaemic control, following intensifying insulin therapy, is associated with improvements in HRQoL. Methods Dutch sub-optimally controlled (HbA(1c) > 7%) type 2 diabetes patients (N = 447, mean age 59 +/- 11) initiated insulin glargine therapy. Data were collected at baseline, 3 and 6 months, and included HbA1c and measures of HRQoL: diabetes symptom distress (Diabetes Symptom Checklist-revised; DSC-r), fear of hypoglycaemia (Hypoglycaemia Fear Survey; HFS-w) and emotional well-being (WHO-5 wellbeing index). Results HbA(1c) decreased from 8.8 +/- 1.4% to 8.0 +/- 1.2% and 7.7 +/- 1.3% at 3 and 6 months follow-up, respectively (P <0.001), DSC-r score improved from 17.7 +/- 14.7 to 14.3 +/- 13.3 and 13.6 +/- 13.3 (P <0.001). HFS-w score did not significantly change. WHO-5 score increased from 56 +/- 23 to 62 +/- 23 and 65 +/- 22 P <0.001). A modest, significant association was found between HbA(1c) and WHO-5 score (B = -1.8, 95% CI: -2.7 to -0.8) and HbA1c and DSC-r score (B = 1.0, 95% CI: 0.4 to 1.6). No such association was found for HFS-w score. Conclusions An association between improvement in HbA(1c) by means of optimising insulin therapy and improvement in HRQoL in type 2 diabetes patients has been observed. A weak, yet significant longitudinal association was found between improved HbA(1c) and emotional well-being and diabetes symptom distress
AB - Purpose To test whether improvement in glycosylated haemoglobin (HbA(1c)) as a marker of glycaemic control, following intensifying insulin therapy, is associated with improvements in HRQoL. Methods Dutch sub-optimally controlled (HbA(1c) > 7%) type 2 diabetes patients (N = 447, mean age 59 +/- 11) initiated insulin glargine therapy. Data were collected at baseline, 3 and 6 months, and included HbA1c and measures of HRQoL: diabetes symptom distress (Diabetes Symptom Checklist-revised; DSC-r), fear of hypoglycaemia (Hypoglycaemia Fear Survey; HFS-w) and emotional well-being (WHO-5 wellbeing index). Results HbA(1c) decreased from 8.8 +/- 1.4% to 8.0 +/- 1.2% and 7.7 +/- 1.3% at 3 and 6 months follow-up, respectively (P <0.001), DSC-r score improved from 17.7 +/- 14.7 to 14.3 +/- 13.3 and 13.6 +/- 13.3 (P <0.001). HFS-w score did not significantly change. WHO-5 score increased from 56 +/- 23 to 62 +/- 23 and 65 +/- 22 P <0.001). A modest, significant association was found between HbA(1c) and WHO-5 score (B = -1.8, 95% CI: -2.7 to -0.8) and HbA1c and DSC-r score (B = 1.0, 95% CI: 0.4 to 1.6). No such association was found for HFS-w score. Conclusions An association between improvement in HbA(1c) by means of optimising insulin therapy and improvement in HRQoL in type 2 diabetes patients has been observed. A weak, yet significant longitudinal association was found between improved HbA(1c) and emotional well-being and diabetes symptom distress
U2 - https://doi.org/10.1007/s11136-011-0051-0
DO - https://doi.org/10.1007/s11136-011-0051-0
M3 - Article
C2 - 22065281
SN - 0962-9343
VL - 21
SP - 1359
EP - 1365
JO - Quality of life research
JF - Quality of life research
IS - 8
ER -