1. Louisville Metabolic and Atherosclerosis Research, Louisville, KY, USA.
3. AstraZeneca LP, Wilmington, DE, USA.
Background: To evaluate whether diminished functionality among adults with type 2 diabetes mellitus (T2DM) is due to implications associated with diagnosis of T2DM, or due to underlying characteristics that predispose to T2DM and ill health.
Methods: This prospective SHIELD study classified respondents into 3 groups: (1) T2DM diagnosis at baseline in 2004, (2) newly diagnosed T2DM from 2005–2009 (ie, "at risk" for T2DM at baseline), and (3) no DM diagnosis at baseline or from 2004–2009. Validated assessments included SF-12 (quality of life), PHQ-9 (depression), IPAQ (physical activity), and WPAI-GH (work impairment). Regression models adjusted for age, obesity, cigarette smoking, cholesterol problems, heart disease, and hypertension.
Results: SF-12 physical health scores were similar between those with T2DM (40.7, n=1837) and at risk for T2DM (41.6, n=473) (p>0.05), but worse versus those without DM (46.5, n=4629) (p<0.01). Depression scores, work impairment, and physical activity were similar between those with T2DM and at risk for T2DM (p>0.05), but worse than for those without DM (p<0.01). Age, obesity, cholesterol problems, and cigarette smoking consistently predicted functioning scores after adjusting for diabetes status.
Conclusions: Age, cigarette smoking, and obesity were factors that had stronger influences on functional scale scores than the diagnosis of T2DM.
Keywords: Type 2 diabetes, health-related quality of life, depression, physical activity, work and activity impairment