Impact of diagnosis of diabetes on health-related quality of life among high risk individuals: the Diabetes Prevention Program outcomes study
D Marrero, Q Pan, E Barrett-Connor, M de Groot, P Zhang, C Percy, H Florez, R Ackermann, M Montez, R R Rubin, DPPOS Research Group, George A Bray, Annie Chatellier, Crystal Duncan, Frank L Greenway, Erma Levy, Donna H Ryan, Kenneth S Polonsky, Janet Tobian, David Ehrmann, Margaret J Matulik, Bart Clark, Kirsten Czech, Catherine DeSandre, Ruthanne Hilbrich, Wylie McNabb, Ann R Semenske, Barry J Goldstein, Kevin Furlong, Kellie A Smith, Wendi Wildman, Constance Pepe, Ronald B Goldberg, Jeanette Calles, Juliet Ojito, Sumaya Castillo-Florez, Hermes J Florez, Anna Giannella, Olga Lara, Beth Veciana, Steven M Haffner, Helen P Hazuda, Maria G Montez, Carlos Lorenzo, Arlene Martinez, Richard F Hamman, Lisa Testaverde, Alexis Bouffard, Dana Dabelea, Tonya Jenkins, Dione Lenz, Leigh Perreault, David W Price, Sheila C Steinke, Edward S Horton, Catherine S Poirier, Kati Swift, Enrique Caballero, Sharon D Jackson, Lori Lambert, Kathleen E Lawton, Sarah Ledbury, Steven E Kahn, Brenda K Montgomery, Wilfred Fujimoto, Robert H Knopp, Edward W Lipkin, Michelle Marr, Anne Murillo, Dace Trence, Abbas E Kitabchi, Mary E Murphy, William B Applegate, Michael Bryer-Ash, Samuel Dagogo-Jack, Sandra L Frieson, Helen Lambeth, Lynne C Lichtermann, Hooman Otkaei, Lily M K Rutledge, Amy R Sherman, Clara M Smith, Judith E Soberman, Beverly Williams-Cleaves, Boyd E Metzger, Mark E Molitch, Mariana K Johnson, Mimi M Giles, Diane Larsen, Charlotte Niznik, Samsam C Pen, Pamela A Schinleber, David M Nathan, Charles McKitrick, Heather Turgeon, Kathy Abbott, Ellen Anderson, Laurie Bissett, Enrico Cagliero, Kali D'Anna, Linda Delahanty, Jose C Florez, Valerie Goldman, Alexandra Poulos, Beverly Tseng, Elizabeth Barrett-Connor, Mary Lou Carrion-Petersen, Javiva Horne, Diana Leos, Sundar Mudaliar, Jean Smith, Karen Vejvoda, F Xavier Pi-Sunyer, Jane E Lee, Sandra T Foo, Susan Hagamen, David G Marrero, Susie M Kelly, Ronald T Ackermann, Edwin S Fineberg, Angela Hadden, Marcia A Jackson, Marion S Kirkman, Kieren J Mather, Paris J Roach, Madelyn L Wheeler, Robert E Ratner, Vanita Aroda, Sue Shapiro, Catherine Bavido-Arrage, Peggy Gibbs, Gabriel Uwaifo, Renee Wiggins, Mohammed F Saad, Karol Watson, Medhat Botrous, Sujata Jinagouda, Maria Budget, Claudia Conzues, Perpetua Magpuri, Kathy Ngo, Kathy Xapthalamous, Neil H White, Samia Das, Ana Santiago, Angela L Brown, Cormarie Wernimont, Christopher D Saudek, Sherita Hill Golden, Tracy Whittington, Jeanne M Clark, Alicia Greene, Dawn Jiggetts, Henry Mosley, John Reusing, Richard R Rubin, Shawne Stephens, Evonne Utsey, David S Schade, Karwyn S Adams, Claire Hemphill, Penny Hyde, Lisa Butler, Janene L Canady, Kathleen Colleran, Ysela Gonzales, Doris A Hernandez-McGinnis, Patricia Katz, Carolyn King, Jill Crandall, Janet O Brown, Elsie Adorno, Helena Duffy, Helen Martinez, Dorothy Pompi, Harry Shamoon, Elizabeth A Walker, Judith Wylie-Rosett, Trevor Orchard, Susan Jeffries, M Kaye Kramer, Marie Smith, Rena R Wing, Andrea Kriska, Jessica Pettigrew, Linda Semler, Elizabeth Venditti, Valarie Weinzierl, Richard F Arakaki, Narleen K Baker-Ladao, Mae K Isonaga, Nina E Bermudez, Marjorie K Mau, William C Knowler, Norman Cooeyate, Mary A Hoskin, Camille Natewa, Carol A Percy, Kelly J Acton, Vickie L Andre, Shandiin Begay, Brian C Bucca, Sherron Cook, Matthew S Doughty, Justin Glass, Martia Glass, Robert L Hanson, Doug Hassenpflug, Louise E Ingraham, Kathleen M Kobus, Jonathan Krakoff, Catherine Manus, Cherie McCabe, Sara Michaels, Tina Morgan, Julie A Nelson, Robert J Roy, Miranda Smart, Darryl P Tonemah, Charlton Wilson, Sarah Fowler, Tina Brenneman, Solome Abebe, Julie Bamdad, Melanie Barkalow, Joel Bethepu, Tsedenia Bezabeh, Jackie Callaghan, Costas Christophi, Sharon L Edelstein, Yuping Gao, Robert Gooding, Adrienne Gottlieb, Nisha Grover, Heather Hoffman, Kathleen Jablonski, Richard Katz, Preethy Kolinjivadi, John M Lachin, Yong Ma, Susan Reamer, Alla Sapozhnikova, Hanna Sherif, Marinella Temprosa, Qing Pan, Mary Foulkes, Nicole Butler, Elizabeth M Venditti, Andrea M Kriska, Linda Semler, Valerie Weinzierl, Santica Marcovina, Greg Strylewicz, John Albers, Ronald J Prineas, Teresa Alexander, Charles Campbell, Sharon Hall, Susan Hensley, Yabing Li, Margaret Mills, Elsayed Soliman, Zhuming Zhang, Ronald Danis, Matthew Davis, Larry Hubbard, Ryan Endres, Deborah Elsas, Samantha Johnson, Vonnie Gama, Anne Goulding, Gregory Evans, Elizabeth Stamm, Jose A Luchsinger, Judith Fradkin, Sanford Garfield, Edward Gregg, Ping Zhang, William H Herman, Morton B Brown, Elizabeth Mayer-Davis, Robert R Moran, Ted Ganiats, Andrew J Sarkin, Naomi Katzir, Erik Groessl, Matthew Budoff, Chris Dailing, D Marrero, Q Pan, E Barrett-Connor, M de Groot, P Zhang, C Percy, H Florez, R Ackermann, M Montez, R R Rubin, DPPOS Research Group, George A Bray, Annie Chatellier, Crystal Duncan, Frank L Greenway, Erma Levy, Donna H Ryan, Kenneth S Polonsky, Janet Tobian, David Ehrmann, Margaret J Matulik, Bart Clark, Kirsten Czech, Catherine DeSandre, Ruthanne Hilbrich, Wylie McNabb, Ann R Semenske, Barry J Goldstein, Kevin Furlong, Kellie A Smith, Wendi Wildman, Constance Pepe, Ronald B Goldberg, Jeanette Calles, Juliet Ojito, Sumaya Castillo-Florez, Hermes J Florez, Anna Giannella, Olga Lara, Beth Veciana, Steven M Haffner, Helen P Hazuda, Maria G Montez, Carlos Lorenzo, Arlene Martinez, Richard F Hamman, Lisa Testaverde, Alexis Bouffard, Dana Dabelea, Tonya Jenkins, Dione Lenz, Leigh Perreault, David W Price, Sheila C Steinke, Edward S Horton, Catherine S Poirier, Kati Swift, Enrique Caballero, Sharon D Jackson, Lori Lambert, Kathleen E Lawton, Sarah Ledbury, Steven E Kahn, Brenda K Montgomery, Wilfred Fujimoto, Robert H Knopp, Edward W Lipkin, Michelle Marr, Anne Murillo, Dace Trence, Abbas E Kitabchi, Mary E Murphy, William B Applegate, Michael Bryer-Ash, Samuel Dagogo-Jack, Sandra L Frieson, Helen Lambeth, Lynne C Lichtermann, Hooman Otkaei, Lily M K Rutledge, Amy R Sherman, Clara M Smith, Judith E Soberman, Beverly Williams-Cleaves, Boyd E Metzger, Mark E Molitch, Mariana K Johnson, Mimi M Giles, Diane Larsen, Charlotte Niznik, Samsam C Pen, Pamela A Schinleber, David M Nathan, Charles McKitrick, Heather Turgeon, Kathy Abbott, Ellen Anderson, Laurie Bissett, Enrico Cagliero, Kali D'Anna, Linda Delahanty, Jose C Florez, Valerie Goldman, Alexandra Poulos, Beverly Tseng, Elizabeth Barrett-Connor, Mary Lou Carrion-Petersen, Javiva Horne, Diana Leos, Sundar Mudaliar, Jean Smith, Karen Vejvoda, F Xavier Pi-Sunyer, Jane E Lee, Sandra T Foo, Susan Hagamen, David G Marrero, Susie M Kelly, Ronald T Ackermann, Edwin S Fineberg, Angela Hadden, Marcia A Jackson, Marion S Kirkman, Kieren J Mather, Paris J Roach, Madelyn L Wheeler, Robert E Ratner, Vanita Aroda, Sue Shapiro, Catherine Bavido-Arrage, Peggy Gibbs, Gabriel Uwaifo, Renee Wiggins, Mohammed F Saad, Karol Watson, Medhat Botrous, Sujata Jinagouda, Maria Budget, Claudia Conzues, Perpetua Magpuri, Kathy Ngo, Kathy Xapthalamous, Neil H White, Samia Das, Ana Santiago, Angela L Brown, Cormarie Wernimont, Christopher D Saudek, Sherita Hill Golden, Tracy Whittington, Jeanne M Clark, Alicia Greene, Dawn Jiggetts, Henry Mosley, John Reusing, Richard R Rubin, Shawne Stephens, Evonne Utsey, David S Schade, Karwyn S Adams, Claire Hemphill, Penny Hyde, Lisa Butler, Janene L Canady, Kathleen Colleran, Ysela Gonzales, Doris A Hernandez-McGinnis, Patricia Katz, Carolyn King, Jill Crandall, Janet O Brown, Elsie Adorno, Helena Duffy, Helen Martinez, Dorothy Pompi, Harry Shamoon, Elizabeth A Walker, Judith Wylie-Rosett, Trevor Orchard, Susan Jeffries, M Kaye Kramer, Marie Smith, Rena R Wing, Andrea Kriska, Jessica Pettigrew, Linda Semler, Elizabeth Venditti, Valarie Weinzierl, Richard F Arakaki, Narleen K Baker-Ladao, Mae K Isonaga, Nina E Bermudez, Marjorie K Mau, William C Knowler, Norman Cooeyate, Mary A Hoskin, Camille Natewa, Carol A Percy, Kelly J Acton, Vickie L Andre, Shandiin Begay, Brian C Bucca, Sherron Cook, Matthew S Doughty, Justin Glass, Martia Glass, Robert L Hanson, Doug Hassenpflug, Louise E Ingraham, Kathleen M Kobus, Jonathan Krakoff, Catherine Manus, Cherie McCabe, Sara Michaels, Tina Morgan, Julie A Nelson, Robert J Roy, Miranda Smart, Darryl P Tonemah, Charlton Wilson, Sarah Fowler, Tina Brenneman, Solome Abebe, Julie Bamdad, Melanie Barkalow, Joel Bethepu, Tsedenia Bezabeh, Jackie Callaghan, Costas Christophi, Sharon L Edelstein, Yuping Gao, Robert Gooding, Adrienne Gottlieb, Nisha Grover, Heather Hoffman, Kathleen Jablonski, Richard Katz, Preethy Kolinjivadi, John M Lachin, Yong Ma, Susan Reamer, Alla Sapozhnikova, Hanna Sherif, Marinella Temprosa, Qing Pan, Mary Foulkes, Nicole Butler, Elizabeth M Venditti, Andrea M Kriska, Linda Semler, Valerie Weinzierl, Santica Marcovina, Greg Strylewicz, John Albers, Ronald J Prineas, Teresa Alexander, Charles Campbell, Sharon Hall, Susan Hensley, Yabing Li, Margaret Mills, Elsayed Soliman, Zhuming Zhang, Ronald Danis, Matthew Davis, Larry Hubbard, Ryan Endres, Deborah Elsas, Samantha Johnson, Vonnie Gama, Anne Goulding, Gregory Evans, Elizabeth Stamm, Jose A Luchsinger, Judith Fradkin, Sanford Garfield, Edward Gregg, Ping Zhang, William H Herman, Morton B Brown, Elizabeth Mayer-Davis, Robert R Moran, Ted Ganiats, Andrew J Sarkin, Naomi Katzir, Erik Groessl, Matthew Budoff, Chris Dailing
Abstract
Purpose: The purpose of this study is to assess if diagnosis of type 2 diabetes affected health-related quality of life (HRQoL) among participants in the Diabetes Prevention Program/Diabetes Prevention Program Outcome Study and changes with treatment or diabetes duration.
Methods: 3,210 participants with pre-diabetes were randomized to metformin (MET), intensive lifestyle intervention (ILS), or placebo (PLB). HRQoL was assessed using the SF-36 including: (1) 8 SF-36 subscales; (2) the physical component (PCS) and mental component summary (MCS) scores; and (3) the SF-6D. The sample was categorized by diabetes free versus diagnosed. For diagnosed subgroup, mean scores in the diabetes-free period, at 6 months, 2, 4 and 6 years post-diagnosis, were compared.
Results: PCS and SF-6D scores declined in all participants in all treatment arms (P < .001). MCS scores did not change significantly in any treatment arm regardless of diagnosis. ILS participants reported a greater decrease in PCS scores at 6 months post-diagnosis (P < .001) and a more rapid decline immediately post-diagnosis in SF-6D scores (P = .003) than the MET or PLB arms. ILS participants reported a significant decrease in the social functioning subscale at 6 months (P < .001) and two years (P < .001) post-diagnosis.
Conclusions: Participants reported a decline in measures of overall health state (SF-6D) and overall physical HRQoL, whether or not they were diagnosed with diabetes during the study. There was no change in overall mental HRQoL. Participants in the ILS arm with diabetes reported a more significant decline in some HRQoL measures than those in the MET and PLB arms that developed diabetes.
Trial registration: ClinicalTrials.gov NCT00004992 NCT00038727.
Figures
Source: PubMed