Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life

OBJECTIVES: Morbidity from GI symptoms in diabetes is considered to be high , but no studies have quantified the impact of GI symptoms in diabetes on h ealth-related quality of life. We hypothesized that diabetics reporting inc reased GI symptoms would experience more impaired quality of life. METHODS: Subjects from the community with diabetes (n = 892) and outpatient s with diabetes (n = 209) were recruited for this study. Subjects were divi ded into type 1 (diabetes diagnosed at age <30 yr and requiring insulin) an d type 2. A validated questionnaire measuring GI symptoms and diabetes stat us and the Short Form-36 were completed. The results were compared with Aus tralian normal data. GI symptom groups measured were frequent abdominal pai n, bowel-related abdominal pain, reflux, dyspepsia, constipation, diarrhea, and fecal incontinence. RESULTS: There was a clinically significant decrease in quality-of-life sco res in diabetics compared with population norms across all subscales. The i mpact on quality of life in diabetes was predominantly observed in type 2 d iabetics. The quality-of-lifo scores in all subscales decreased markedly wi th increasing numbers of distinct GI symptom groups, and this was similar i n community and outpatient diabetics. For all the Short Form-36 subscales, GI symptom groups were significantly (all p < 0.0001) associated with poore r quality of life in diabetes, independent of age, gender, smoking, alcohol use, and type of diabetes. CONCLUSIONS: GI symptoms impact negatively on health-related quality of lif t: in diabetes mellitus. (Am J Gastroenterol 2001;96:71-76. (C) 2001 by Am. Coll. of Gastroenterology).