Worsening Diabetes Complications Lower Quality of Life in Type 1 Diabetes, Suggests Study

Researchers, led by Sara Barraud, MD, from CRESTIC and the Department of Endocrinology, Diabetes and Nutrition at CHU de Reims, France, analysed baseline data from adults enrolled in the Société Francophone du Diabète – Cohorte Diabète de Type 1 (SFDT1) study. The team aimed to understand how various complications related to type 1 diabetes affect daily well-being and perceived health status, using both generic and disease-specific quality-of-life assessment tools.

The analysis included 1,892 adults, nearly half of whom were women, with a median age of 38 years. Health-related quality of life (HRQoL) was evaluated using the EQ-5D-5L questionnaire and the Audit of Diabetes-Dependent Quality of Life (ADDQoL) scale. Complication severity was measured using an adapted Diabetes Complications Severity Index (DCSI), which ranged from 0 to 14 in the study population.

Overall, participants reported a mean EQ-5D-5L score of 71.1 out of 100, reflecting moderate perceived health. Several domains of daily functioning were notably affected:

• 14% reported mobility issues

• 5% had difficulty with self-care

• 19% struggled with usual activities

• 45% experienced pain or discomfort

• 52% reported anxiety or depression symptoms

The median DCSI score was 1, indicating that many participants already had at least one complication. Importantly, the severity of complications showed a clear and consistent link with declining HRQoL. After adjusting for multiple factors, the researchers found that each one-point increase in DCSI was tied to a 1.5% drop in overall HRQoL scores. This negative association extended to most domains measured by both the generic and diabetes-specific questionnaires, except anxiety/depression and a few lifestyle-related ADDQoL domains, such as freedom to eat or drink.

To illustrate the impact, the authors noted that two individuals with similar characteristics—but differing in complication severity—would show meaningful differences in life quality. For example, a person with mild diabetic retinopathy, peripheral neuropathy, and a past myocardial infarction would, on average, report a 6% lower HRQoL than someone without complications.

The study highlights the significant burden that diabetes-related complications place on daily life and emotional well-being. However, the researchers also highlighted certain limitations. Since the analysis was cross-sectional, it cannot establish causality, and the findings are based on self-reported measures that may not fully reflect clinical status. Additionally, the study population was drawn from a French cohort, which may limit the general applicability of the results to other healthcare settings.

Despite these constraints, the findings reinforce the importance of early detection, proactive management, and prevention of complications in type 1 diabetes. Strengthening these efforts, the authors noted, could play a crucial role in improving long-term quality of life for people living with the condition.

Reference:

Barraud S, Aguayo GA, Cosson E, Amouyal C, Feldman S, Gautier JF, Vaduva P, Hadjadj S, Hanaire H, Kessler L, Lecornet-Sokol E, Massin P, Potier L, Renard E, Reznik Y, Sola A, Vambergue A, Vatier C, Vergès B, Riveline JP, Fagherazzi G. Severity of complications is associated with impaired health-related quality of life in people with type 1 diabetes. Diabetes Obes Metab. 2025 Dec 2. doi: 10.1111/dom.70306. Epub ahead of print. PMID: 41328549.