In a recent issue of Diabetes Care, Hill-Briggs et al. (1) found that the Medical Outcomes Study 36-item short form (SF-36) did not improve in a population whose outcome measures (HbA1c, triglycerides, and diastolic blood pressure) showed modest improvement. We found a similar lack of change in the standard SF-36 in a group of patients whose HbA1c levels, measured in a boronate affinity assay in which the upper limit of normal was 6.8%, fell >3.0% from an initial median of 11.9% (2). Hill-Briggs et al. suggested that diabetes-specific questions be either added to the SF-36 or used alone to evaluate the impact of diabetes interventions on health status and health-related quality of life. We selected the latter by including the following two diabetes-specific questions (developed by Ron Hayes, PhD, Rand Corp., Santa Monica, CA) in our study.
1) During the past months how much did your diabetes cause a problem with each of the following?
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Doing things on the spur-of-the-moment
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The amount of time or inconvenience involved in treating your diabetes
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Maintaining a diet and preparing food
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Having a large appetite for food
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Feeling embarrassed in public while managing your diabetes
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Taking a trip or going on vacation
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Pain or discomfort involved in taking care of your diabetes
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Doing things socially with friends/relatives
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Planning meals or eating out with others
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Your family life, getting along with others
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Having to plan things differently to take care of your diabetes
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Lack of interest in sex or enjoyment of sex
2) Overall, how much of a problem is it to live a normal life and take care of your diabetes?
Responses were given the following discrete scores: very much a problem (0), somewhat of a problem (33), a little bit of a problem (66), not a problem (100), and not applicable. Thus, the higher the score, the more positive the answer. These items were scored in the same manner as the standard SF-36 form. Both of them improved significantly in our population (2), validating the suggestion by Hill-Briggs et al.
Footnotes
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