Health status assessed by the SF-36 along the diabetes continuum in an Australian population Catherine R. Chittleborough 1 , Katherine L. Baldock 1 , Anne W. Taylor 2 , Patrick J. Phillips 3 & The North West Adelaide Health Study Team 1 South Australian Department of Health, Diabetes Clearing House, Population Research and Outcome Studies Unit, South Australia, Australia; 2 South Australian Department of Health, Population Research and Outcome Studies Unit, South Australia, Australia; 3 Endocrine and Diabetes Service, The Queen Elizabeth Hospital and Health Service, South Australia, Australia (E-mail: catherine.chittleborough@ health.sa.gov.au) Accepted in revised form 27 September 2005 Abstract Objective: To examine the association of health status with stage along the diabetes continuum. Design, setting and participants: Self-reported health status (SF-36) was assessed in the North West Adelaide Health Study, a representative population cohort (n=4060) aged 18 years and over in metropolitan South Aus- tralia. Impaired fasting glucose (IFG), undiagnosed diabetes, diagnosed diabetes, glycaemic control and cardiovascular disease were determined from fasting blood and self-reported data. Results: The prevalence of diagnosed diabetes was 5.6% (95% CI: 4.9–6.3), with an additional 1.0% (95% CI: 0.7–1.4) previously undiagnosed. When compared to those with normal glucose, those with diabetes were significantly impaired on all SF-36 dimensions except Mental Health, and those with IFG (4.3%) were significantly impaired in terms of Physical Functioning and Bodily Pain when controlling for the effects of age, sex and cardio- vascular disease. Poor glycaemic control (HbA1c ‡ 7.0%) was also associated with impaired health status. Conclusions: Health status is impaired not only among those with diagnosed diabetes but also those with IFG and undiagnosed diabetes. Key words: Diabetes Mellitus, Glycosylated, Health status, Hemoglobin A, Quality of life, SF-36 Abbreviations: FPG – Fasting plasma glucose; HRQL – Health-related quality of life; IFG – Impaired fasting glucose Introduction Diabetes is associated with significant burden in terms of health, social, economic and emotional costs, and is thus recognised as a health priority in Australia [1]. Over a decade of population studies in South Australia have shown diabetes to be a disease that has a substantial effect on functioning, pre- mature mortality and health service use [2]. The complexity of diabetes is such that it requires dili- gent day to day management in order to maintain good metabolic control. Poor management and control of diabetes often leads to poor disease outcomes, including impaired health-related quality of life (HRQL) and health status. Numerous studies have demonstrated the diminished HRQL and health status experienced by those with diabetes compared to those without diabetes [3–5], those with impaired glucose toler- ance [4], and those with other chronic conditions [2, 6]. Studies have also examined the effect of glucose control on HRQL [4, 7, 8]. For those with diabetes, differences between those with type 1 and type 2 diabetes [9], and the effect of complications Quality of Life Research (2006) 15: 687–694 Ó Springer 2006 DOI 10.1007/s11136-005-3570-8