Association Between Baseline Diabetes Therapy-Related Quality of Life (DTR-QOL) and Subsequent Risk of All-Cause Mortality: A Prospective Cohort Study (Diabetes Distress and Care Registry at Tenri [DDCRT 26]).

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-06-10 DOI:10.1007/s13300-025-01755-2

Yuichi Nishioka, Yasuaki Hayashino, Kentaro Kurosawa, Kiyoko Takano, Satoshi Matsunaga, Shintaro Okamura, Satoru Tsujii, Hitoshi Ishii

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Abstract

Introduction: We aimed to examine a cohort of people with diabetes to prospectively determine the association between diabetes therapy-related quality of life (DTR-QOL) and the subsequent risk of all-cause mortality.

Methods: Longitudinal data of 3795 individuals with diabetes were obtained from a single-center diabetes registry from 2011. To assess the association between DTR-QOL at baseline and the subsequent risk of all-cause mortality, a Cox proportional hazards model was used with adjustment for baseline potential confounders (age, sex, duration of diabetes, body mass index [BMI], glycated hemoglobin [HbA1c] level, urinary albumin/creatinine ratio, history of diabetic retinopathy, symptomatic diabetic neuropathy, medical history, type of diabetes, and diabetes prescriptions).

Results: We observed 425 deaths during a median follow-up of 8.7 years. The median (interquartile range) age and HbA1c level were 66 (60-74) years and 6.9% (6.7-8.1%), respectively. The DTR-QOL was significantly associated with younger age, female sex, higher BMI, higher HbA1c level, higher proportion of symptomatic diabetic neuropathy, higher proportion of diabetic retinopathy, and higher proportion of insulin use. In total, 425 deaths occurred during the study period. Compared with the third tertile group of DTR-QOL scores, the hazard ratios (HRs) were consistently 1.38 times higher in the first tertile group. Lower scores on "burden on social activities and daily activities" domain were associated with a higher HR, while lower scores on the other domains ("anxiety and dissatisfaction with therapy," "hypoglycemia," and "satisfaction with therapy") were not.

Conclusion: A lower QOL related to diabetes therapy in people with diabetes was found to be associated with an increased risk of future mortality. Graphical Abstract available for this article.

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基线糖尿病治疗相关生活质量（DTR-QOL）与随后全因死亡风险之间的关系：一项前瞻性队列研究（Tenri的糖尿病困扰和护理登记处[DDCRT 26]）。

前言：我们旨在研究一组糖尿病患者，以前瞻性地确定糖尿病治疗相关生活质量（DTR-QOL）与随后的全因死亡风险之间的关系。方法：从2011年的单中心糖尿病登记处获得3795名糖尿病患者的纵向数据。为了评估基线DTR-QOL与随后全因死亡风险之间的关系，采用Cox比例风险模型，调整基线潜在混杂因素（年龄、性别、糖尿病病程、体重指数（BMI）、糖化血红蛋白（HbA1c）水平、尿白蛋白/肌酐比、糖尿病视网膜病变史、症状性糖尿病神经病变、病史、糖尿病类型和糖尿病处方）。结果：在中位随访8.7年期间，我们观察到425例死亡。中位年龄（四分位数范围）和HbA1c水平分别为66岁（60-74岁）和6.9%（6.7-8.1%）。DTR-QOL与年龄较小、女性、BMI较高、HbA1c水平较高、症状性糖尿病神经病变比例较高、糖尿病视网膜病变比例较高、胰岛素使用比例较高相关。在研究期间，总共有425人死亡。与第三分位组的DTR-QOL评分相比，第一分位组的风险比（hr）始终高出1.38倍。在“社会活动负担和日常活动”领域得分较低与较高的人力资源相关，而在其他领域得分较低（“对治疗的焦虑和不满意”，“低血糖”和“对治疗的满意度”）则不相关。结论：糖尿病患者较低的生活质量与糖尿病治疗相关，与未来死亡风险增加相关。本文提供的图形摘要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.