Ethnicity and Diabetic Quality-of-Life.

Publisher: Elsevier Country of Publication: United States NLM ID: 0370506 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-2990 (Electronic) Linking ISSN: 00029629 NLM ISO Abbreviation: Am J Med Sci Subsets: MEDLINE

Publication: 2016- : New York : Elsevier
Original Publication: Philadelphia : J. B. Lippincott

Black or African American*/statistics & numerical data ; White People*/statistics & numerical data; Diabetes Mellitus, Type 1/*ethnology ; Diabetes Mellitus, Type 2/*ethnology ; Quality of Life/*psychology; Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Diabetes Complications/drug therapy ; Diabetes Complications/ethnology ; Diabetes Complications/psychology ; Diabetes Mellitus, Type 1/drug therapy ; Diabetes Mellitus, Type 1/psychology ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/psychology ; Female ; Humans ; Insulin/administration & dosage ; Insulin/therapeutic use ; Male ; Middle Aged ; Regression Analysis ; Surveys and Questionnaires ; United States ; Young Adult

Background: Multiple studies have addressed ethnic diabetes mellitus (diabetes) care inequalities. But few have assessed whether ethnicity influences patient perceptions of diabetic quality-of-life (QOL). The authors therefore designed a cross-sectional study to quantify the overall QOL associated with diabetes in consecutive white (Caucasian) and black (African-American) participants.
Material and Methods: A validated, time tradeoff utility instrument was consecutively administered by interview to 518 white and 92 African-American, adult, diabetic participants in an ambulatory setting. The instrument calculates QOL by quantifying a utility associated with their condition, with utility anchors of 1.00 (perfect health for that condition permanently) and 0.00 (death). Utility acquisition as used herein, first requires asking participants to estimate their theoretical remaining time of life, then subtracting from 1.00 the maximum proportion of their estimated remaining time of life they would be willing to hypothetically trade-if any-to permanently cure their condition (diabetes). Thus, a diabetic participant estimating 20 remaining years of life who will theoretically trade 3 of those years to cure their diabetes, has a diabetes-associated utility of [1.00 - (3/20) =)] 0.85. The closer the utility is to 1.00, the better the QOL associated with a condition, while the closer it is to 0.00, the poorer the associated QOL.
Results: The mean diabetes utility (QOL) for the white, diabetic participant cohort was 0.87, while that for the black cohort was 0.86 (P = 0.95). The ethnic cohorts were matched for age (P = 0.70), sex (P = 0.64), level of education (P = 0.29), known years of having diabetes (P = 0.10), insulin use (P = 0.23), type of diabetes (P = 0.27) and the number of associated comorbidities (P = 0.23). There was no difference between the cohorts for the presence and severity of the individual, diabetes-related comorbidities of retinopathy (P = 0.15), nephropathy (P = 0.24), neuropathy (P = 0.52), depression (P = 0.23) and heart disease (P = 0.32). Multiple linear regression integrating both cohorts revealed no effect of ethnicity upon diabetes utility (P = 0.60).
Conclusions: Diabetes-related QOL was similar in matched cohorts of adult white and black participants with diabetes mellitus. This study suggests utilities for diabetes mellitus can be used in economic analyses without adjustment for white and black ethnicity.
(Copyright © 2019. Published by Elsevier Inc.)

Keywords: Diabetes; Ethnicity; Quality-of-life

0 (Insulin)

Date Created: 20190724 Date Completed: 20200130 Latest Revision: 20221207

20221213

10.1016/j.amjms.2019.04.007

31331449