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Peggy P. Chiang, Yingfeng Zheng, Mohamed Dirani, Jing Xie, Rehab Benarous, Tien Y. Wong, Ecosse L. Lamoureux; Determinants of Diabetes-Related Quality of Life in Patients with Diabetic Retinopathy: The Diabetes Management Project. Invest. Ophthalmol. Vis. Sci. 2011;52(14):608.
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To identify the specific independent determinants of diabetes-related quality of life (QoL) in patients with diabetic retinopathy (DR).
Patients with type I or II diabetes aged 18 years or older were recruited from specialized eye clinics in Melbourne, Australia. All participants underwent a series of validated questionnaires, a detailed ocular examination and blood sample was collected for biochemical parameters. Dilated fundus photographs were obtained using a non-mydriatic fundus camera, and the severity of DR was graded using the modified Airlie House classification system. The impact of diabetes on QoL was measured by the ‘Audit of Diabetes Dependent Quality of Life’ (ADDQoL) questionnaire. Depression and anxiety were assessed using the Hospital Depression and Anxiety scale (HADS) and diabetes self-efficacy used the Stanford Patient Education Research scale.
Of the 492 (mean age = 66 years; males: 325) included in the analysis, 321 (65.2%) had DR. Of these, 187 (58.3%) had non-proliferative DR (NPDR) and 134 (41.7%) had proliferative DR (PDR). Patients with DR had significantly lower QoL than persons without DR [odds ratio (OR) 0.67, p=<0.0001; 95% confidence interval (CI) 0.54, 0.83] after adjusting for depression, self-efficacy, and anxiety. In patients with DR, independent determinants of QoL were: presence of PDR (β=-1.34, p=0.025; 95% CI -2.52, -0.17); gender (β=0.69, p=0.046; 95% CI 0.01, 1.37, females); higher low density lipoprotein cholesterol (β=-0.32, p=0.026; 95% CI -0.59, -0.04); and depression (β=-0.67, p=0.003; 95% CI -1.11, -0.23, per positive score increase). These factors accounted for 10.2% of the total variance in diabetes-related QoL.
Taking into account of these modifiable risk factors in patients with DR may lead to a better diabetes-related QoL.
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