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Author:
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Alcubierre Calvo, Núria; Rubinat, Esther; Traveset Maeso, Alicia; Martínez Alonso, Montserrat; Hernandez, Marta; Jurjo Campo, Carmen; Mauricio Puente, Dídac
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Notes:
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Background: To assess quality of life and treatment satisfaction in patients with type 2 diabetes mellitus with diabetic
retinopathy (DR) using validated instruments, with comparison to patients without DR.
Methods: A prospective cross-sectional study was designed to assess the influence of retinopathy on quality of life and
treatment satisfaction in patients with type 2 diabetes mellitus who do not have any other advanced late complications
that could interfere with these outcomes. We included 148 patients with DR and 149 without DR, all without
other advanced diabetic complications. Quality of life was assessed using the Audit of Diabetes Dependent Quality of Life
(ADDQoL) questionnaire, and treatment satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire
(DTSQ). Clinical and treatment variables related to diabetes were also collected. The degree of DR was classified according
to the International Clinical Classification System. Multivariate linear regression models were used to model the ADDQoL
and DTSQ scores according to sociodemographical and clinical characteristics, and to model the adjusted relationship of
DTSQ with ADDQoL. In DR patients, a subanalysis assessed the relationship of these scores with the degree of retinopathy,
severity of macular edema, and previous photocoagulation treatment.
Results: DR was associated with significantly lower quality of life (p < 0.001), when examining the two general quality
of life items and most of the specific domains. Concerning DTSQ, no difference was found in the total score, and only
two domains that assess the perception of glycemic control (hyper- and hypoglycemia) showed a worse score in DR
(p < 0.001 and p = 0.008, respectively). Quality of life was significantly affected by the severity of DR, and treatment
satisfaction was significantly affected by the severity of macular edema. In the multivariate analysis, a significant effect
of the interaction between diabetes duration, insulin therapy, and the presence of DR was found for both, ADDQoL
and DTSQ.
Conclusion: In the absence of other major complications, DR has a negative impact on quality of life in patients with
type 2 diabetes. Further, treatment satisfaction was not affected by the presence of DR.
This study was supported by grant PS09/01035 from Instituto de Salud Carlos III. |
