The North West Adelaide Health Study

Transcription

1 North Diabetes can ruin your day Quality of life after diagnosis Catherine Chittleborough, Patrick Phillips, Maria Drakoulas, Katherine Baldock, Anne Taylor, & the North Team

2 The North Biomedical cohort study Established in 2000 Collaboration between The Queen Elizabeth Hospital, Lyell McEwin Service, South Australian Department of, University of, University of South Australia Designed to assess prevalence of priority conditions, risk factors and determinants across continuum, and progression over time

3 South Australia

4 North, South Australia

5 Background People with diabetes experience impaired quality of life compared to those without diabetes. People with impaired fasting glucose also have impaired quality of life compared to those without diabetes. Poor glucose control is associated with impaired quality of life International/national evidence Stage 1 data from North

6 Aim To examine the effect of development of diabetes on quality of life using longitudinal data from the North.

7 Methods Households randomly selected from Electronic White Pages Approach letter sent to households CATI Person last to have birthday, aged 18+ years, selected Appointment made to attend clinic Information pack sent including questionnaire

8

9 Clinic assessment Fasting blood test (glucose, lipids, glycated haemoglobin, creatinine) Blood pressure Height and weight Waist and hip circumference Lung function spirometry Skin allergies

10 Response rate - Stage 1 ( ) Initial sample n=10096 Eligible sample n=8213 Interviewed n=5850 Attended clinic n=4060 Ineligible n= % Non-contacts n= % Refused interview n= % Refused clinic n= % Attended clinic / interviewed = 69.4% participation rate Attended clinic / eligible sample = 49.4% response rate

11 Response rate - Stage 2 ( ) Initial sample n=4060 Eligible sample n=3957 (97.5%) Information obtained n=3564 (90.1%) Deceased n=100 Duplicate IDs n=3 Non-contacts n=233 (5.9%) No information obtained n=160 (4.0%) Telephone interview n= % Questionnaire n= % Attended clinic n= %

12 Diabetes continuum No diabetes IFG 6.1 mmol/l Diabetes ( 7.0 mmol/l or self-reported) STAGE 1 (n=4060) 89.1% 4.3% 6.6%

13 Diabetes continuum No diabetes IFG 6.1 mmol/l Diabetes ( 7.0 mmol/l or self-reported) STAGE 1 (n=4060) 89.1% 4.3% 6.6% STAGE 2 (n=3180) 84.8% 8.0% 7.2% Annual incidence of diabetes: 6.8 cases per 1000 population

14 Quality of life Short Form 36 (SF-36) 8 scales Physical functioning Role physical Bodily pain General health Vitality Social functioning Role emotional Mental health

15 QOL publication

16 Mean SF-36 scores across the diabetes continuum 100 Normal Glucose IFG Diabetes Score PF RP BP GH VT SF RE MH SF-36 Dimension Significantly different to normal glucose (p<0.01) (adjusted for age, sex, cardiovascular disease)

17 Mean SF-36 scores for people with and without diabetes Score No Diabetes Diabetes with good glycaemic control Diabetes with poor glycaemic control + + PF RP BP GH VT SF RE MH SF-36 Dimension Significantly different to No Diabetes (p<0.01) + Significantly different to Diabetes with good glycaemic control (p<0.01) (adjusted for age, sex, cardiovascular disease)

18 Development of diabetes and quality of life at Stage 2 Mean score Did not develop diabetes Developed diabetes Already had diabetes PF RP BP GH VT SF RE MH SF-36 dimension Significantly different to Did not develop diabetes (p<0.01) (adjusted for age and sex)

19 Was the change in QoL over time greater for those who developed diabetes than those who did not? SF-36 scale Coefficient (95% CI) p value PF 2.99 (-1.64,7.63) 0.21 RP (1.07,19.03) 0.03 BP (-9.06,1.90) 0.20 GH (-9.11,0.08) 0.05 VT (-7.94,1.02) 0.13 SF (-5.57,4.67) 0.86 RE 3.70 (-3.92,11.32) 0.34 MH (-7.20,-0.66) 0.02

20 Changes in QoL over time (MH) Mean at S1 Mean at S2 difference Did not develop diabetes Developed diabetes

21 Conclusions Quality of life is impaired as diabetes develops. Management of newly diagnosed diabetes should consider quality of life.

22 Contact details North Population Research & Outcome Studies Unit (SA Department of )