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© 2004 by the American Diabetes Association, Inc.
Epidemiology/Health Services/Psychosocial Research |
Health-Related Quality of Life and Health-Adjusted Life Expectancy of People With Diabetes in Ontario, Canada, 1996–1997
1 Department of Public Health Sciences, University of Toronto, Toronto, Canada
2 Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Canada
Address correspondence and reprint requests to Dr. Douglas G. Manuel, Institute for Clinical Evaluative Sciences G106-2075 Bayview Ave., Toronto, Ontario, M4N 3M5 Canada. E-mail: doug.manuel{at}ices.on.ca
OBJECTIVE—To estimate the burden of illness from diabetes using a population health survey linked to a population-based diabetes registry.
RESEARCH DESIGN AND METHODS—Measures of health-related quality of life (HRQOL) from the 1996/97 Ontario Health Survey (n = 35,517) were combined with diabetes prevalence and mortality data from the Ontario Diabetes Database (n = 487,576) to estimate the impact of diabetes on life expectancy, health-adjusted life expectancy (HALE), and HRQOL.
RESULTS—Life expectancy of people with diabetes was 64.7 and 70.7 years for men and women, respectively—12.8 and 12.2 years less than that for men and women without diabetes. Diabetes had a large impact on instrumental and basic activities of daily living, more so than on functional health. HALE was 58.3 and 62.7 years, respectively, for men and women—11.9 and 10.7 years less than that of men and women without diabetes. Eliminating diabetes would increase Ontario life expectancy by 2.8 years for men and 2.6 years for women; HALE would increase by 2.7 and 3.2 years for men and women, respectively.
CONCLUSIONS—The burden of illness from diabetes in Ontario is considerable. Efforts to reduce diabetes would likely result in a "compression of morbidity." An approach of estimating diabetes burden using linked data sources provides a robust approach for the surveillance of diabetes.
Abbreviations: ADL, basic activity of daily living • CIDI, Composite International Diagnostic Interview • DALY, disability-adjusted life-year • HALE, health-adjusted life expectancy • HRQOL, health-related quality of life • HUI3, Health Utilities Index • IADL, instrumental activity of daily living • NPHS, National Population Health Survey • ODD, Ontario Diabetes Database • OHS II, 1996/97 Ontario Health Survey • RPDB, Registered Persons Database • SMPH, summary measures of population health • WHO, World Health Organization
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