HRQOL using EQ5D utility scores
Diabetic patients reported an average
EQ5D utility score of 0.74 (SD 0.27),
which is only slightly lower than the
scores seen in individuals of similar age in
the general population (U.K. population:
60–69 years of age; women 0.81, men
0.78) (Table 1) (12). Women, older patients,
and patients with a longer duration
of diabetes reported a lower HRQOL than
other patients. Both insulin therapy and
presence of complications were associated
with a lower quality of life. Patients
without complications reported the highest
HRQOL, whereas patients with both
microvascular and macrovascular complications
reported the lowest HRQOL
(i.e., 0.191 units lower). Patients with
only microvascular complications and patients
with only macrovascular complications
reported an HRQOL between these
two extremes. Obesity was associated
with a lower utility score (0.07 units).
Higher fasting blood glucose and HbA1c
levels were associated with a lower utility
score, although the association seen for
HbA1c was more pronounced (a decrease
of 0.02 Euroqol units per increase in
HbA1c by 1%) (Table 2).
Multivariate analysis resulted in a
model containing age, female sex, obesity,
insulin therapy, microvascular complications
only, macrovascular complications
only, and both microvascular and macrovascular
complications (Table 2). Multilevel
modeling showed that only 1.6% of
the variance in EQ5D utility scores was
seen at the general practitioner level and
98.4% was seen at the patient level. The
differences between the model based on
linear regression and the model based on
multilevel modeling were insubstantial.
HRQOL using EQ5D utility scores
Diabetic patients reported an average
EQ5D utility score of 0.74 (SD 0.27),
which is only slightly lower than the
scores seen in individuals of similar age in
the general population (U.K. population:
60–69 years of age; women 0.81, men
0.78) (Table 1) (12). Women, older patients,
and patients with a longer duration
of diabetes reported a lower HRQOL than
other patients. Both insulin therapy and
presence of complications were associated
with a lower quality of life. Patients
without complications reported the highest
HRQOL, whereas patients with both
microvascular and macrovascular complications
reported the lowest HRQOL
(i.e., 0.191 units lower). Patients with
only microvascular complications and patients
with only macrovascular complications
reported an HRQOL between these
two extremes. Obesity was associated
with a lower utility score (0.07 units).
Higher fasting blood glucose and HbA1c
levels were associated with a lower utility
score, although the association seen for
HbA1c was more pronounced (a decrease
of 0.02 Euroqol units per increase in
HbA1c by 1%) (Table 2).
Multivariate analysis resulted in a
model containing age, female sex, obesity,
insulin therapy, microvascular complications
only, macrovascular complications
only, and both microvascular and macrovascular
complications (Table 2). Multilevel
modeling showed that only 1.6% of
the variance in EQ5D utility scores was
seen at the general practitioner level and
98.4% was seen at the patient level. The
differences between the model based on
linear regression and the model based on
multilevel modeling were insubstantial.
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