Quality of Life Impacts from Type 1 Diabetes: Evidence from Two Studies in Northern Sweden

University essay from Lunds universitet/Nationalekonomiska institutionen

Abstract: Purpose: To estimate the impact upon Health-Related Quality of Life (HRQOL) associated with Type 1 Diabetes Mellitus (T1DM), both with and without associated diabetic complications, for enabling calculation of utility values – Quality of Life Weights (QLW) – for populations with T1DM. Method: Two cohorts from Northern Sweden, one of T1DM patients and one of a general population, were given surveys measuring their health quality, using the EQ-5D tool. In total, a combined 1,825 persons replied to the surveys. Controlling for both personal characteristics and cardiovascular disease (CVD), the differences in HRQOL were estimated using different regression models. HRQOL was analyzed through both EQ-5D-3L – using three different value sets to ensure the sensitivity of the results – and EQ-VAS. Results: T1DM was significantly correlated with lower HRQOL. This decrease was estimated to range between -3.2 and -2.1 percentage points (depending on which value set was used) when controlling for CVD, and between -3.8 and -2.4 percentage points, when only controlling for background characteristics. The drop in HRQOL in life amongst the T1DM patients could partly be explained through their increased prevalence of associated diabetic complications. Since T1DM is also associated with an elevated risk of microvascular complications, and these complications were found to lower HRQOL, it is likely these are another cause of the lower HRQOL among T1DM patients. No evidence was found that cardiovascular complications have a different impact upon HRQOL of T1DM patients than upon a general population. Conclusions: This study has estimated QLWs for both a T1DM and general population, and the decrease in HRQOL that is associated with T1DM, both when the prevalence of cardiovascular complications is known and not. Associated complications can explain part of the drop in HRQOL amongst T1DM patients, but T1DM also appears to have a direct negative effect on HRQOL besides through increasing the risk of associated complications.

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