The Influence of Cardiovascular Disease on Quality of Life in Type 2 Diabetics

Background and Aims: In type 2 diabetes mellitus, disease-related complications have a considerable effect on the quality of life. We studied the influence of cardiovascular disease on quality of life in type 2 diabetic patients in a longitudinal design. We also studied whether quality of life in any way predicts the manifestation of cardiovascular disease. Materials and methods: A prospective cohort study from April 1996 to October 1999. In 1996 and 1999 all known type 2 diabetics from the population of Urk, the Netherlands, were invited by their general practitioners (GPs) for extensive check-up. In both years quality of life was assessed using the generic RAND-36 and the disease-specific Diabetes Health Profile (DHP). In the intermediate period, cardiovascular morbidity and mortality were registered by the GPs. Results: In 1996, 281 patients were examined and 248 (88.3%) persons completed the questionnaires. After 3 years 189 persons (67.3%) were re-examined and 161 (85.2%) handed in the questionnaire. When compared to diabetics without cardiovascular disease, diabetics with cardiovascular disease had a lower quality of life. Multiple regression analysis showed that contracting cardiovascular disease negatively affects the RAND-36 dimensions 'social functioning', 'vitality' and 'health change'. Cox's regression analysis showed a negative relation between the RAND-36 dimensions 'physical functioning', and time to the manifestation of cardiovascular disease. The DHP appeared not to be suitable to measure quality of life in relation to cardiovascular disease. Conclusions: In type 2 diabetics, cardiovascular disease has a negative effect on quality of life. A decreased quality of life is associated with a short-term manifestation of cardiovascular disease.