A longitudinal study on the association between diabetic foot disease and health related quality of life in people with type 2 diabetes

AbstractObjectivesTo assess the association between diabetic foot disease and health related quality of life (HRQOL) during a two-year follow-up among people with type 2 diabetes in Alberta. MethodsA type 2 diabetes cohort was established (2011-2013); those with self-reported diabetic foot disease were identified. HRQOL was assessed at baseline, one, and two years. The SF-12 Physical Component Summary (PCS), Mental Component Summary (MCS), and the EQ-5D-5L were collected. The association between diabetic foot disease and changes in HRQOL was assessed using General Linear Mixed Model (GLMM) after adjustment for socio-demographics, previous health care use, Elixhauser co-morbidities index, baseline health status, and diabetes specific behaviors. ResultsAmong the cohort (n=969), average age was 64.3 (SD 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, 9.82); MCS: 4.33 (95%CI: 2.99, 5.67); EQ-5D-5L index score: 0.12 (95% CI: 0.09, 0.14). After adjustment, no differences were observed in the score changes at year two (PCS: 0.16, 95% CI: -0.88, 1.21; MCS: 0.36, 95% CI: -0.77, 1.50; EQ-5D-5L index score: 0.004, 95% CI: -0.01, 0.02). ConclusionAlthough participants with diabetic foot disease reported lower HRQOL at baseline, they had similar changes compared to those without diabetic foot disease during the two-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.