Diabetes-specific quality of life but not health status is independently associated with glycaemic control among patients with type 2 diabetes: A cross-sectional analysis of the ADDITION-Europe trial cohort Laura Kuznetsov a , Simon J. Griffin a , Melanie J. Davies b , Torsten Lauritzen c , Kamlesh Khunti b , Guy E.H.M. Rutten d , Rebecca K. Simmons a, * a MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom b Diabetes Research Unit, Leicester Diabetes Centre, University of Leicester, Leicester, United Kingdom c Department of Public Health, Section of General Practice, University of Aarhus, Aarhus, Denmark d Julius Center, Department of General Practice, University Medical Center Utrecht, Utrecht, Netherlands d i a b e t e s r e s e a r c h a n d c l i n i c a l p r a c t i c e 1 0 4 ( 2 0 1 4 ) 2 8 1 – 2 8 7 a r t i c l e i n f o Article history: Received 25 June 2013 Received in revised form 25 November 2013 Accepted 21 December 2013 Available online 15 January 2014 Keywords: Health status Diabetes-specific quality of life ADDQoL SF-36 HbA1c Type 2 diabetes a b s t r a c t Aims: To examine the association between health status, diabetes-specific quality of life (QoL) and glycaemic control among individuals with type 2 diabetes. Methods: 1876 individuals with screen-detected diabetes and a mean age of 66 years under- went assessment of self-reported health status (SF-36), diabetes-specific QoL (the Audit of Diabetes Dependent Quality of Life (ADDQoL19)) and glycated haemoglobin (HbA1c) at five years post-diagnosis in the ADDITION-Europe trial. Multivariable linear regression was used to quantify the cross-sectional association between health status, diabetes-specific QoL and HbA1c, adjusting for age, sex, education, alcohol consumption, physical activity, BMI, intake of any glucose-lowering drugs, and trial arm. Results: The mean (SD) SF-36 physical and mental health summary scores were 46.2 (10.4) and 54.6 (8.6), respectively. The median average weighted impact ADDQoL score was 0.32 (IQR 0.89 to 0.06), indicating an overall negative impact of diabetes on QoL. Individuals who reported a negative impact of diabetes on their QoL had higher HbA1c levels at five years after diagnosis compared with those who reported a positive or no impact of diabetes (b-coefficient [95% CI]: b = 0.2 [0.1, 0.3]). Physical and mental health summary SF-36 scores were not significantly associated with HbA1c in multivariable analysis. Conclusions: Diabetes-specific QoL but not health status was independently associated with HbA1c. Practitioners should take account of the complex relationship between diabetes- specific QoL and glucose, particularly with regard to dietary behaviour. Future research should attempt to elucidate via which pathways this association might act. # 2013 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: MRC Epidemiology Unit, University of Cambridge, Box 285, Hills Road, Cambridge CB2 0QQ, United Kingdom. Tel.: +44 0 1223 330315; fax: +44 0 1223 330316. E-mail address: rebecca.simmons@mrc-epid.cam.ac.uk (R.K. Simmons). Contents available at ScienceDirect Diabetes Research and Clinical Practice journal homepage: www.elsevier.com/locate/diabres 0168-8227/$ – see front matter # 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.diabres.2013.12.029