Glycemia and the Quality of Well-Being in Patients with Diabetes

Abstract

Objectives : To investigate the cross-sectional relationships among self-reported frequencies of symptomatic hyperglycemia and hypoglycemia, HbA1c, and symptoms in the Quality of Well-Being Self-Administered (QWB-SA), and to examine the associations among these measures of glycemia and health utility scores. Research design and methods : The study group included 1522 patients with diabetes who attended University of Michigan Health System clinics. Published studies were reviewed to identify symptoms in the QWB-SA that might be associated with measures of glycemia. Linear regression analyses were performed to evaluate the strength of the associations among the frequency of self-reported measures of glycemia, QWB-SA symptoms, and QWB-SA-derived health utility scores. Results : Frequency of hyperglycemic symptoms was associated with 3% of the variance in the QWB-SA-derived health utility score in type 1 diabetes and with 5% of the variance in type 2 diabetes. Frequency of hypoglycemic symptoms was not associated with the QWB-SA-derived health utility score in type 1 diabetes but was associated with 1% of the variance in type 2 diabetes. HbA1c levels were not significantly associated with QWB-SA-derived health utility scores. After controlling for age, gender, and complications, frequency of hyperglycemic symptoms was significantly associated with QWB-SA-derived health utility scores in type 1 and type 2 diabetes. Conclusions : Reported frequency of hyperglycemic symptoms is associated with symptoms included in the QWB-SA and with QWB-SA-derived health utility scores. The QWB-SA may be an appropriate measure to assess the health burden of hyperglycemia.