Decrements in health-related quality of life associated with adverse events in people with diabetes.

AIM: People with diabetes are at elevated risk of adverse events due to the disease and treatments. We estimate the decrements in health-related quality of life (QoL) associated with a range of adverse events. This will inform assessments of the effects of diabetes treatments on QoL in contemporary clinical practice. METHODS: Participants' QoL utility measures were derived from the five-level EuroQoL five-dimensional (EQ-5D-5L) questionnaires completed by 11683 ASCEND participants (76% of 15480 recruited). EQ-5D utility decrements associated with cardiovascular (myocardial infarction, coronary revascularisation, transient ischaemic attack (TIA), ischaemic stroke, heart failure), bleeding (gastrointestinal (GI) bleed, intracranial haemorrhage, other major bleed), cancer (GI tract cancer, non-GI tract cancer), and microvascular events (end-stage renal disease (ESRD), amputation) were estimated using linear regression model following adjustment for participants' socio-demographic and clinical risk factors. RESULTS: Amputation was associated with the largest EQ-5D utility decrement (-0.206), followed by heart failure (-0.185), intracranial haemorrhage (-0.164), GI bleed (-0.091), other major bleed (-0.096), ischaemic stroke (-0.061), TIA (-0.057), and non-GI tract cancer (-0.026). We were unable to detect decrements in EQ-5D utility associated with myocardial infarction, coronary revascularisation, GI tract cancer or ESRD. EQ-5D utility was lower at older age, independent of other factors. CONCLUSION: These estimated decrements in QoL associated with cardiovascular, bleeding, cancer and other adverse events can inform assessments of overall value of treatments in patients with diabetes. This article is protected by copyright. All rights reserved.