PURPOSE: To investigate changes of vision-related quality of life during a 10-year period in a population with type 1 diabetes. DESIGN: Prospective cohort study. PARTICIPANTS: Individuals who had their diabetes diagnosed before 30 years of age were considered to have type 1 diabetes (N = 1210). Those who participated in both 14-year (1995-1996) and 25-year (2005-2007) follow-up examinations were included in the current analysis (N = 471). METHODS: Vision-related quality of life was measured with the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). MAIN OUTCOME MEASURES: Changes in vision-related quality of life scores. RESULTS: Loss of 3 lines in the Early Treatment Diabetic Retinopathy Study (ETDRS) chart was the most important factor related to negative changes in the NEI-VFQ-25 scores in our study after controlling for confounders. Most important changes were observed in subscales, such as general vision (-6.46 points), mental health (-10.19 points), role difficulty (-6.90 points), and driving (-10.43 points). Unemployment and the development of long-term complications, such as nephropathy, were also associated with negative changes in some NEI-VFQ-25 subscale scores. However, changes in diabetic retinopathy status were not related to changes in any subscale after 10 years. CONCLUSIONS: Change in visual acuity was the most important factor associated with changes in vision-related quality of life scores in individuals with type 1 diabetes during a 10-year period. Our findings support the necessity of close follow-up of individuals with type 1 diabetes to avoid development of long-term complications and vision loss to improve quality of life.
PURPOSE: To investigate changes of vision-related quality of life during a 10-year period in a population with type 1 diabetes. DESIGN: Prospective cohort study. PARTICIPANTS: Individuals who had their diabetes diagnosed before 30 years of age were considered to have type 1 diabetes (N = 1210). Those who participated in both 14-year (1995-1996) and 25-year (2005-2007) follow-up examinations were included in the current analysis (N = 471). METHODS: Vision-related quality of life was measured with the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). MAIN OUTCOME MEASURES: Changes in vision-related quality of life scores. RESULTS: Loss of 3 lines in the Early Treatment Diabetic Retinopathy Study (ETDRS) chart was the most important factor related to negative changes in the NEI-VFQ-25 scores in our study after controlling for confounders. Most important changes were observed in subscales, such as general vision (-6.46 points), mental health (-10.19 points), role difficulty (-6.90 points), and driving (-10.43 points). Unemployment and the development of long-term complications, such as nephropathy, were also associated with negative changes in some NEI-VFQ-25 subscale scores. However, changes in diabetic retinopathy status were not related to changes in any subscale after 10 years. CONCLUSIONS: Change in visual acuity was the most important factor associated with changes in vision-related quality of life scores in individuals with type 1 diabetes during a 10-year period. Our findings support the necessity of close follow-up of individuals with type 1 diabetes to avoid development of long-term complications and vision loss to improve quality of life.
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