Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2019; 10(2): 87-95
Published online Feb 15, 2019. doi: 10.4239/wjd.v10.i2.87
Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy
Anne-Marie L Wegeberg, Theresa Meldgaard, Sofie Hyldahl, Poul Erik Jakobsen, Asbjørn M Drewes, Birgitte Brock, Christina Brock
Anne-Marie L Wegeberg, Theresa Meldgaard, Sofie Hyldahl, Asbjørn M Drewes, Christina Brock, Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Aalborg 9000, Denmark
Poul Erik Jakobsen, Asbjørn M Drewes, Steno Diabetes Center North Judland, Region Nordjylland, Aalborg 9000, Denmark
Birgitte Brock, Steno Diabetes Center Copenhagen, Region Hovedstaden, Gentofte 2820, Denmark
Christina Brock, Department of Pharmacotherapy and Development, University of Copenhagen, Copenhagen 1071, Denmark
Author contributions: Brock C and Brock B conceptualised the study; Brock C, Brock B, Jakobsen PE and Drewes AM designed the study; Meldgaard T acquired the data; Wegeberg AML, Hyldahl S and Brock C interpreted data; Wegeberg AML drafted the manuscript and all author contributed intellectual property and approved the final version; the authors declare that there is no conflict of interest associated with this manuscript.
Supported by Aalborg University; Novo Nordisk Scandinavia AS; Empowering Industry and Research EIR Northern Jutland; during the conduct of the study; and Innovation Fund Denmark, Individuals, Disease and Society, Copenhagen, Denmark.
Institutional review board statement: The study was approved by The North Denmark Region Committee on Health Research Ethics, Denmark (N-20130077).
Informed consent statement: All subjects gave their informed consent prior to inclusion.
Conflict-of-interest statement: Dr. Brock reports grants from Aalborg University, from Novo Nordisk Scandinavia AS, from Empowering Industry and Research EIR Northern Jutland, grants from Innovation Fund Denmark, Individuals, Disease and Society, Copenhagen, Denmark, during the conduct of the study.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Christina Brock, DVM, PhD, Associate Professor, Senior Scientist, Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, Aalborg 9000, Denmark. christina.brock@rn.dk
Telephone: +45-97-660510
Received: January 2, 2019
Peer-review started: January 4, 2019
First decision: January 12, 2019
Revised: January 16, 2019
Accepted: February 11, 2019
Article in press: February 12, 2019
Published online: February 15, 2019
Processing time: 46 Days and 19.7 Hours
Abstract
BACKGROUND

A large number of adults with long-term type 1 diabetes are affected by symmetrical peripheral neuropathy. These complications increase socioeconomic expenses and diminish the individual quality of life. The 36-Item Short Form Health Survey (SF-36) is a generic patient reported questionnaire, measuring mental and physical health related quality of life. We hypothesized that diabetic neuropathy would decrease physical and mental quality of life measured with SF-36, and that clinical appearance may be associated with the decline.

AIM

To investigate if diabetic neuropathy would decrease physical and mental quality of life measured with SF-36, and if clinical appearance may be associated with the decline.

METHODS

Forty-eight adults [age 50 ± 9 years, 10 females, disease duration 32 (14-51) years] with verified diabetic symmetrical peripheral neuropathy and 21 healthy participants (age 51 ± 6 years, 6 females) underwent standardised nerve conduction testing and completed the SF-36 questionnaire. Furthermore, disease duration, number of comorbidities, both diabetes related and nondiabetes related, vibration perception threshold, number of hypoglycaemic events, HbA1c and administration way of insulin was notified.

RESULTS

In comparison to healthy subjects, patients’ mental composite score was not significantly diminished (51.9 ± 8.9 vs 53.1 ± 5.5, P = 0.558), while the physical composite score was (46.3 ± 11.7 vs 54.6 ± 3.3, P = 0.002). As expected, the overall physical health related symptoms in patients were associated to total number of comorbidities (P < 0.0001), comorbidities relation to diabetes (P = 0.0002) and HbA1c (P = 0.005) as well as comorbidities not related to diabetes (P = 0.0006).

CONCLUSION

The finding of this study emphasises the importance of focusing on quality of life in adults with diabetes and especially in those with multiple comorbidities as well as the possibility of HbA1c as a biomarker for severe complication.

Keywords: Quality of life; 36-Item Short Form Health Survey (SF-36); Diabetes mellitus, Type 1; Diabetic neuropathies; Comorbidity

Core tip: In this study, we found a diminishment of physical domains more so than mental components from the 36-Item Short Form Health Survey (SF-36), in 48 people with type 1 diabetes and verified diabetic symmetrical peripheral neuropathy when compared to 21 healthy controls. Additionally, this physical diminishment was associated with increases in number of comorbidities and HbA1c. To our knowledge a study of health related quality of life exclusively in people with type 1 diabetes and diabetic symmetrical peripheral neuropathy compared to healthy age-matched controls has not previously been performed, therefore these results are interesting for health care professionals interested in the connection between neuropathy and patient experience.