Abstract
Objectives
The aim of this study was to assess the association between diabetic foot disease
and health-related quality of life (HRQOL) during a 2-year follow up among people
with type 2 diabetes in Alberta.
Methods
A type 2 diabetes cohort was established (2011‒2013); those with self-reported diabetic
foot disease were identified. HRQOL was assessed at baseline and 1 and 2 years. Scores
from the 12-item Short Form Physical Component Summary (PCS) and Mental Component
Summary (MCS) and the EuroQol 5-Dimension 5-Level (EQ-5D-5L) instrument were collected.
The association between diabetic foot disease and changes in HRQOL was assessed using
the general linear mixed model after adjustment for sociodemographics, previous health-care
use, Elixhauser comorbidities index, baseline health status and diabetes-specific
behaviours.
Results
Among the cohort (n=969), average age was 64.3 (standard deviation, 10.0) years and
55% were male. Overall, 265 (27.4%) participants reported having diabetic foot disease.
Those with diabetic foot disease reported lower HRQOL in comparison to those without
diabetic foot disease at baseline: PCS, 8.44 (95% confidence interval [CI], 7.06 to
9.82); MCS, 4.33 (95% CI, 2.99 to 5.67) and EQ-5D-5L index score, 0.12 (95% CI, 0.09
to 0.14). After adjustment, no differences were observed in the score changes at year
2 (PCS, 0.16 [95% CI, -0.88 to 1.21]; MCS, 0.36 [95% CI, -0.77 to 1.50]; EQ-5D-5L
index score, 0.004 [95% CI, -0.01 to 0.02]).
Conclusions
Although participants with diabetic foot disease reported lower HRQOL at baseline,
they had similar changes compared to those without diabetic foot disease during the
2-year follow up. Efforts to maintain general health and early intervention to prevent
diabetic foot disease may help to avoid initial deterioration of physical health and
HRQOL.
RÉSUMÉ
Objectifs
Le but de cette étude était d'évaluer l'association entre une condition de pied diabétique
et la qualité de vie liée à la santé (QVLS) au cours d'un suivi de deux ans chez les
personnes atteintes de diabète de type 2 en Alberta.
Méthodes: Une cohorte de diabétiques de type 2 a été établie (2011-2013); ceux qui
avaient déclaré eux-mêmes un pied diabétique ont été identifiés. La QVLS a été évaluée
au départ et après une période de 1 et 2 ans. Les notes obtenues aux 12 points du
questionnaire abrégé du Bilan de Santé Physique (BSP) et du Bilan de Santé Mentale
(BSM) en 12 points, ainsi que celles de l'instrument descriptif à 5 dimensions de
5 niveaux EuroQol (EQ-5D-5L). L'association entre une condition de pied diabétique
et les changements de la QVLS a été évaluée à l'aide du modèle linéaire mixte généralisé
après ajustement pour les facteurs sociodémographiques, de l'utilisation antérieure
de soins de santé, de l'indice de comorbidités Elixhauser, de l'état de santé initial
et des comportements propres au diabète.
Résultats: Dans la cohorte (n=969), l'âge moyen était de 64.3 ans (écart-type, 10.0)
et 55% étaient des hommes. Dans l'ensemble, 265 participants (27.4%) ont déclaré souffrir
d'un pied diabétique. Les personnes atteintes d'un pied diabétique ont déclaré une
QVLS inférieure à celle des personnes sans pied diabétique au début de l'étude: BSP,
8.44 (intervalle de confiance à 95%[IC], 7.06 à 9.82); BSM, 4.33 (IC à 95%, 2.99 à
5.67); et indice EQ-5D-5L, 0,12 (IC à 95%, 0.09 à 0.14). Après ajustement, aucune
différence n'a été observée dans les changements de score après 2 ans (BSP, 016[IC
à 95%, -0.88 à 1.21]; BSM, 0.36 [IC à 95%, -0.77 à 1.50]; indice EQ-5D-5L, 0.004[IC
à 95%, -0.01 à 0.02]).
Conclusions
Bien que les participants atteints d'un pied diabétique aient déclaré initialement
une QVLS inférieure, ils ont connu des changements semblables à ceux des participants
sans pied diabétique au cours du suivi de deux ans. Les efforts visant à maintenir
l'état de santé général et une intervention précoce pour prévenir le pied diabétique
peuvent aider à éviter la détérioration initiale de la santé physique et de la QVLS.
Keywords
Mots clés
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Article info
Publication history
Published online: August 25, 2019
Accepted:
August 19,
2019
Received in revised form:
July 25,
2019
Received:
April 15,
2019
Identification
Copyright
© 2019 Canadian Diabetes Association.
