THE HEALTH AND FUNCTIONAL STATUS OF VETERANS WITH DIABETES

OBJECTIVE - To determine the extent of functional impairment among vet erans with diabetes and investigate whether such functional impairment is associated with measures of glycemic control, sensory neuropathy, lower extremity macrovascular disease, or other comorbid conditions. R ESEARCH DESIGN AND METHODS - A 20-item general health survey (SF-20) d eveloped by the Medical Outcomes Study (MOS) Group, was administered t o 577 subjects participating in a prospective study of risk factors fo r diabetic foot ulceration. Measures of glycemic control and neurovasc ular disease included GHb, sensory lower extremity neuropathy assessed by aesthesiometry, and segmental lower extremity doppler blood pressu res. RESULTS - Veterans with diabetes have major decreases in all doma ins of functional status; 87% were in poor health in terms of physical functioning and 86% in terms of health perceptions. Those with advanc ing age, symptoms of neuropathy and claudication, and a medical histor y of complications associated with diabetes had significantly more imp airment of health status than those without. GHb values did not correl ate with functional status measures. Subjects with neuropathy had stat istically significant functional impairment. Subjects with vasculopath y had only two significantly low health status measures. CONCLUSIONS - in summary, the findings from this survey reveal that veterans with d iabetes have low functional status scores. The presence of symptoms an d complications accounts for only part of the impairments experienced by this group.