Observational Study
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World J Diabetes. Aug 15, 2014; 5(4): 569-576
Published online Aug 15, 2014. doi: 10.4239/wjd.v5.i4.569
Fifteen-year follow-up of quality of life in type 1 diabetes mellitus
Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Joost C Keers, Henk JG Bilo, Nanne Kleefstra
Peter R van Dijk, Susan JJ Logtenberg, Klaas H Groenier, Henk JG Bilo, Nanne Kleefstra, Diabetes Centre, Isala, 8000 GK Zwolle, The Netherlands
Susan JJ Logtenberg, Henk JG Bilo, Nanne Kleefstra, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
Klaas H Groenier, Department of General Practice, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
Joost C Keers, Research Institute, Martini Hospital, 9728 NT Groningen, The Netherlands
Henk JG Bilo, Department of Internal Medicine, Isala, 8000 GK Zwolle, The Netherlands
Nanne Kleefstra, Langerhans Medical Research Group, 8000 GK Zwolle, The Netherlands
Author contributions: Keers JC, Bilo HJG and Kleefstra N designed the research; van Dijk PR and Logtenberg SJJ performed the research; van Dijk PR, Logtenberg SJJ and Groenier KH contributed to statistical analysis; van Dijk PR, Logtenberg SJJ, Groenier KH, Keers JC, Bilo HJG and Kleefstra N contributed to interpretation of data and writing of the paper.
Correspondence to: Peter R van Dijk, MD, Diabetes Center, Isala, PO Box 10400, 8000 GK Zwolle, The Netherlands. p.r.van.dijk@isala.nl
Telephone: +31-38-4247942 Fax: +31-38-4247695
Received: February 14, 2014
Revised: April 11, 2014
Accepted: May 16, 2014
Published online: August 15, 2014
Processing time: 174 Days and 22.4 Hours
Abstract

AIM: To evaluate metabolic control and health-related quality of life (HRQOL) in a type 1 diabetes mellitus (T1DM) population.

METHODS: As part of a prospective cohort study, 283 T1DM patients treated with various insulin treatment modalities including multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII) were examined annually. HRQOL was measured using the SF-36 and EuroQol questionnaires. Data regarding HRQOL, glycaemic and metabolic control from baseline and follow-up measures in 2002 and 2010 were analysed. Linear mixed models were used to calculate estimated values and differences between the three moments in time and the three treatment modalities.

RESULTS: Significant changes [mean Δ (95%CI)] in body mass index [2.4 kg/m2 (1.0, 3.8)], systolic blood pressure [-6.4 mmHg (-11.4, -1.3)] and EuroQol-VAS [-7.3 (-11.4, -3.3)] were observed over time. In 2010, 168 patients were lost to follow-up. Regarding mode of therapy, 52 patients remained on MDI, 28 remained on CSII, and 33 patients switched from MDI to CSII during follow-up. Among patients on MDI, HRQOL decreased significantly over time: mental component summary [-9.8 (-16.3, -3.2)], physical component summary [-8.6 (-15.3, -1.8)] and EuroQol-VAS [-8.1 (-14.0, -2.3)], P < 0.05 for all. For patients using CSII, the EuroQol-VAS decreased [-9.6 (-17.5, -1.7)]. None of the changes over time in HRQOL differed significantly with the changes over time within the other treatment groups.

CONCLUSION: No differences with respect to metabolic and HRQOL parameters between the various insulin treatment modalities were observed after 15 years of follow-up in T1DM patients.

Keywords: Type 1 diabetes mellitus, Health-related quality of life, Glycaemic control, Insulin treatment, Multiple daily injections, Continuous subcutaneous insulin infusion

Core tip: The results of this study demonstrate that over a period of 15 years, general health-related quality of life is almost stable among patients with type 1 diabetes mellitus. In addition, no differences with respect to metabolic control and general health-related quality of life were observed among type 1 diabetes mellitus patients treated with different insulin regimens (multiple daily injections or continuous subcutaneous insulin infusion).