EQ-5D-3L Decrements by Diabetes Complications and Comorbidities in China

Yichen Zhang; Jing Wu; Yingyao Chen; Lizheng Shi

doi:10.1007/s13300-020-00788-z

EQ-5D-3L Decrements by Diabetes Complications and Comorbidities in China

Diabetes Ther. 2020 Apr;11(4):939-950. doi: 10.1007/s13300-020-00788-z. Epub 2020 Mar 9.

Authors

Yichen Zhang¹, Jing Wu², Yingyao Chen³, Lizheng Shi⁴

Affiliations

¹ Department of Health Policy and Management, Tulane University, New Orleans, LA, 70112, USA.
² School of Pharmaceutical Science and Technology, Tianjin University, 300072, Tianjin, China. jingwu@tju.edu.cn.
³ School of Public Health, Fudan University, 200032, Shanghai, China.
⁴ Department of Health Policy and Management, Tulane University, New Orleans, LA, 70112, USA. lshi1@tulane.edu.

Abstract

Introduction: Patients with type 2 diabetes have lower quality of life, which is further impaired by diabetes complications and comorbidities. This study aims to evaluate the impact of diabetes complications and comorbidities on EuroQol Five-Dimension Three-Level (EQ-5D-3L) scores among patients with type 2 diabetes with ongoing oral drug treatments in China.

Methods: This retrospective cross-sectional analysis included 9570 patients with type 2 diabetes on oral drug treatments, who were enrolled from 75 hospitals in nine cities in China. Patient characteristics, including demographic data, health conditions, oral treatment history, and health insurance coverage, were collected through self-reported questionnaires. Health utility was measured by the EQ-5D-3L scale in the questionnaire and a Chinese version of the EQ-5D-3L scoring weights was applied in the analysis. The associations between complications and health utility were assessed using linear regression.

Results: A total of 7081 patients with complete survey data were included in the analytic sample; 3479 (49.13%) patients were female. The mean age was 59.6 years old, with a standard deviation (SD) of 12.64. The average duration with type 2 diabetes was 7.91 (SD = 6.22) years. A total of 5189 (73.28%) patients reported complications. Hypertension (51.25%) and hyperlipidemia (28.90%) were the most common complications. Other complications reported by patients included cardiovascular disease, stroke, retinopathy, nephropathy, diabetic foot, and hypoglycemia. On average, each patient had 1.54 complications. All complications and comorbidities decreased the EQ-5D-3L score. Among patients with complications, the worst effect on EQ-5D-3L score was caused by diabetic foot, decreasing by 0.118 (p < 0.001), followed by stroke (decreasing by 0.101, p < 0.001) and nephropathy (decreasing by 0.058, p < 0.001).

Conclusion: The diabetes complications and comorbidities among patients with type 2 diabetes were associated with poor health utility scores, especially for those with diabetic foot, stroke, and nephropathy.

Keywords: Complications; Quality of life; Type 2 diabetes.