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Diabetes Res Clin Pract. 2014 May;104(2):281-7. doi: 10.1016/j.diabres.2013.12.029. Epub 2014 Jan 15.

Diabetes-specific quality of life but not health status is independently associated with glycaemic control among patients with type 2 diabetes: a cross-sectional analysis of the ADDITION-Europe trial cohort.

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MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.
Diabetes Research Unit, Leicester Diabetes Centre, University of Leicester, Leicester, United Kingdom.
Department of Public Health, Section of General Practice, University of Aarhus, Aarhus, Denmark.
Julius Center, Department of General Practice, University Medical Center Utrecht, Utrecht, Netherlands.
MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom. Electronic address:



To examine the association between health status, diabetes-specific quality of life (QoL) and glycaemic control among individuals with type 2 diabetes.


1876 individuals with screen-detected diabetes and a mean age of 66 years underwent assessment of self-reported health status (SF-36), diabetes-specific QoL (the Audit of Diabetes Dependent Quality of Life (ADDQoL19)) and glycated haemoglobin (HbA1c) at five years post-diagnosis in the ADDITION-Europe trial. Multivariable linear regression was used to quantify the cross-sectional association between health status, diabetes-specific QoL and HbA1c, adjusting for age, sex, education, alcohol consumption, physical activity, BMI, intake of any glucose-lowering drugs, and trial arm.


The mean (SD) SF-36 physical and mental health summary scores were 46.2 (10.4) and 54.6 (8.6), respectively. The median average weighted impact ADDQoL score was -0.32 (IQR -0.89 to -0.06), indicating an overall negative impact of diabetes on QoL. Individuals who reported a negative impact of diabetes on their QoL had higher HbA1c levels at five years after diagnosis compared with those who reported a positive or no impact of diabetes (b-coefficient [95% CI]: b=0.2 [0.1, 0.3]). Physical and mental health summary SF-36 scores were not significantly associated with HbA1c in multivariable analysis.


Diabetes-specific QoL but not health status was independently associated with HbA1c. Practitioners should take account of the complex relationship between diabetes-specific QoL and glucose, particularly with regard to dietary behaviour. Future research should attempt to elucidate via which pathways this association might act.


ADDQoL; Diabetes-specific quality of life; HbA1c; Health status; SF-36; Type 2 diabetes

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