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Diabetes Care Publish Ahead of Print published online ahead of print March 4, 2008
DOI: 10.2337/dc07-2072
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Original Research

Prediction of Mortality in Type 2 Diabetes from Health Related Quality of Life (ZODIAC–4).

Nanne Kleefstra, MD1,,2, Gijs W.D. Landman, MD3, Sebastiaan T. Houweling, MD, PhD2,,4, Lielith J. Ubink-Veltmaat, MD, PhD5, Susan J.J. Logtenberg, MD1, Betty Meyboom-de Jong, MD, PhD6, James C. Coyne, PhD7, Klaas H. Groenier, PhD6 and Henk J.G. Bilo, MD, PhD1,,8

1Diabetes Centre, Isala Clinics, Zwolle
2Langerhans Medical Research Group, Zwolle
3Department of Internal Medicine, Isala Clinics, Zwolle
4General Practice Sleeuwijk, Sleeuwijk
5General Practice ‘t Veen, Hattem
6Department of General Practice, University of Groningen, Groningen
8Department of Internal Medicine, University Medical Center Groningen, Groningen; The Netherlands
7Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia; USA

Kleefstra{at}Langerhans.com

ABSTRACT

Objective: To investigate the relationship between health related quality of life (HRQOL) and mortality in type 2 diabetes.

Research Design And Methods: In 1998, 1143 primary care patients with type 2 diabetes participated in the ZODIAC study. At baseline, HRQOL was assessed with the RAND-36 and after almost 6 years life status was retrieved. Cox proportional Hazard modeling was used to investigate the association between HRQOL (continuous data) and mortality, with adjustment for selected confounders (smoking, age, sex, diabetes duration, HbA1c, renal function, BMI, blood pressure, cholesterol/HDL and macrovascular complications).

Results: The Physical Component Summary of the RAND-36 was inversely associated with mortality (HR: 0.979, 95%CI: 0.966 to 0.992), as were two separate RAND-36 dimensions.

Conclusions: This study found that HRQOL is an independent marker of mortality and emphasizes the importance of looking beyond clinical parameters in patients with type 2 diabetes.


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