The impact of diabetes and co-morbidity on health-related quality of life

Approximately 13.5% of individuals over the age of 75 reported having a diagnosis of diabetes in the 1998/99 National Population Health Survey (NPHS), compared to 1.0% of individuals aged 20 to 39.4 Type 2 diabetes accounts for 90% of the diagnosed cases of diabetes in Canada, with type 1 diabetes representing the majority of the remaining 10% of cases. [...] The greater range of possible scores on the HUI3, its enhanced ability to assess the utility of states worse than dead and improved ability to discriminate moderate to severe impairment from mild or no impairment might favor the use of the HUI3 over the HUI2 in assessing HRQL in diabetes.49 Using the HUI2 produced higher utility scores than the HUI3 for individuals with moderate to severe impairme [...] Additional evidence of the construct validity of the HUI3 has been generated at the population level for arthritis and stroke.51 Given the body of evidence supporting the construct validity of the HUI3 in diabetes, stroke and arthritis, it would be a reasonable choice of generic preference-based measures of HRQL in the evaluation of comorbid medical conditions on HRQL deficits in diabetes, given t [...] Number of medications has been shown to be negatively correlated with HRQL58 and functional status59, perhaps because as the number of medications increases, the risk of drug-drug interactions and drug-disease interactions increases.60 The diverse nature of the attributes captured by the HUI3 should permit us to capture the effects of the four sentinel conditions simultaneously with a single instr [...] Data Analysis To assess the impact of the sentinel medical conditions on overall HUI3 utility scores and the eight attributes of the HUI3, analysis of covariance (ANCOVA) models were used, with the determinants of health variables and proxy status entered into the model as covariates.