Quality of life in people with type 2 diabetes in the 3 years following initiation of second-line therapy: The DISCOVER study. (March 2022)

• Record Type: Journal Article
• Authors: Nicolucci, Antonio; Chen, Hungta; Cooper, Andrew; Fenici, Peter; Gomes, Marilia B.; Hammar, Niklas; Ji, Linong; Khunti, Kamlesh; Kosiborod, Mikhail; Medin, Jennie; Shestakova, Marina V.; Shimomura, Iichiro; Tang, Fengming; Vora, Jiten; Watada, Hirotaka; Arnold, Suzanne V.
• Is Part Of: Diabetes research and clinical practice. Volume 185(2022)
• Publication Date: 2022-03
• Subjects: Type 2 diabetes -- Health-related quality of life -- Fear of hypoglycaemia; HRQoL Health-related quality of life -- T2D Type 2 diabetes mellitus -- SF-36v2 Short-Form Health Survey version 2 -- HFS-II Hypoglycaemia Fear Survey II -- MCS Mental component summary -- PCS Physical component summary -- LCGM Latent class growth modelling; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.109218
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: In a global study of patients with early stage T2D, HRQoL was stable over 3 years, on average in the overall cohort. Latent class growth modelling identified subgroups with distinct HRQoL trajectories. A decline in HRQoL over time was observed in small groups. In these groups, patients were older, had a lower socioeconomic economic status and more comorbidities. Use of insulin and sulfonylureas also appeared to be associated with decreased HRQoL. Abstract: Aims: To assess changes in health-related quality of life (HRQoL) in DISCOVER, a 3-year, longitudinal, observational study of patients with type 2 diabetes initiating a second-line glucose-lowering therapy. Methods: HRQoL was assessed using the physical and mental component summary (PCS and MCS) scores of the 36-item Short-Form Health Survey version 2 (score ranges: 0–100; higher denotes better HRQoL) and the Hypoglycaemia Fear Survey II (HFS-II; score range: 0–132 scale; higher indicates greater fear of hypoglycaemia). Latent class growth modelling (LCGM) was used to identify patients with similar score trajectories. Results: Mean baseline PCS (n = 7428), MCS (n = 7453), and HFS-II (n = 5005) scores were 48.0, 45.4, and 15.4, respectively, and remained stable during follow-up. LCGM revealed subgroups with low or decreasing HRQoL. Patients in these subgroups tended to be older, had more comorbidities, and a lower socioeconomic status than in other subgroups. Use of insulin and sulfonylureas was highest in the subgroup with the highest fear of hypoglycaemia. Conclusions: Overall, HRQoL remained stable in DISCOVER patients during follow-up. However, LCGM suggests that some patient characteristics and use of sulfonylureas or insulin are associated with low or decreasing HRQoL, potentially warranting the use of alternative therapies.