Decrements in health-related quality of life associated with adverse events in people with diabetes

Diabetes Obes Metab. 2022 Mar;24(3):530-538. doi: 10.1111/dom.14610. Epub 2021 Dec 20.

Abstract

Aim: To estimate the decrements in health-related quality of life (QoL) associated with a range of adverse events to inform assessments of the effects of diabetes treatments on QoL in contemporary clinical practice.

Methods: Participants' QoL utility measures were derived from the five-level EuroQoL five-dimensional (EQ-5D-5L) questionnaires completed by 11 683 ASCEND participants (76% of 15 480 recruited). EQ-5D utility decrements associated with cardiovascular (myocardial infarction, coronary revascularization, transient ischaemic attack [TIA], ischaemic stroke, heart failure), bleeding (gastrointestinal [GI] bleed, intracranial haemorrhage, other major bleed), cancer (GI tract cancer, non-GI tract cancer), and microvascular events (end-stage renal disease [ESRD], amputation) were estimated using a linear regression model following adjustment for participants' sociodemographic and clinical risk factors.

Results: Amputation was associated with the largest EQ-5D utility decrement (-0.206), followed by heart failure (-0.185), intracranial haemorrhage (-0.164), GI bleed (-0.091), other major bleed (-0.096), ischaemic stroke (-0.061), TIA (-0.057), and non-GI tract cancer (-0.026). We were unable to detect decrements in EQ-5D utility associated with myocardial infarction, coronary revascularization, GI tract cancer, or ESRD. EQ-5D utility was lower at older age, independent of other factors.

Conclusion: These estimated decrements in QoL associated with cardiovascular, bleeding, cancer, and other adverse events can inform assessments of the overall value of treatments in patients with diabetes.

Keywords: cardiovascular disease; diabetes complications; health economics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Ischemia*
  • Diabetes Mellitus*
  • Health Status
  • Humans
  • Quality of Life
  • Stroke* / epidemiology
  • Stroke* / etiology
  • Surveys and Questionnaires