Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes: ACCORD trial

Roger T. Anderson, K. M.Venkat Narayan, Patricia Feeney, David Goff, Mohammed K. Ali, Debra L. Simmons, Jo Ann Sperl-Hillen, Thomas Bigger, Robert Cuddihy, Patrick J. O'Conner, Ajay Sood, Ping Zhang, Mark D. Sullivan

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE - To compare the effect of intensive versus standard glycemic control strategies on health-related quality of life (HRQL) in a substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. RESEARCH DESIGN AND METHODS - A randomly selected subsample of 2,053 ACCORD participants enrolled in the HRQL substudy was assessed at baseline and 12-, 36-, and 48-month visits. HRQL assessment included general health status (the 36-Item Short Form Health Survey [SF-36]), diabetes symptoms (the Diabetes Symptom Distress Checklist), depression (Patient Health Questionnaire [PHQ]-9), and treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire [DTSQ]). Repeated-measures ANOVA models were used to estimate change in HRQL outcomes by treatment group over 48 months adjusting for model covariates. The effects of early discontinuation of the ACCORD intensive glycemic control arm on study results were explored. RESULTS-A total of 1,956 (95%) completed the self-report HRQL instrument(s) at baseline. The intensive arm had a larger decrease in SF-36 physical health component score than the standard arm (-1.6 vs. -1.1, P = 0.0345). Treatment satisfaction (DTSQ) showed larger improvement with intensive than standard (P = 0.0004). There were no differences in mean scores of the Diabetes Symptom Checklist and PHQ-9. Effects of participant transition following discontinuation of the intensive arm on HRQL were not significant. CONCLUSIONS - The ACCORD trial strategy of intensive glycemic control did not lead to benefits in HRQL and was associated with modest improvement in diabetes treatment satisfaction. Thus patient acceptability was apparently not compromised with intensive and complex interventions such as those used in ACCORD.

Original languageEnglish (US)
Pages (from-to)807-812
Number of pages6
JournalDiabetes Care
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2011
Externally publishedYes

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Type 2 Diabetes Mellitus
Quality of Life
Checklist
Health
Therapeutics
Health Surveys
Self Report
Health Status
Analysis of Variance
Research Design
Depression
Surveys and Questionnaires

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Anderson, R. T., Narayan, K. M. V., Feeney, P., Goff, D., Ali, M. K., Simmons, D. L., ... Sullivan, M. D. (2011). Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes: ACCORD trial. Diabetes Care, 34(4), 807-812. https://doi.org/10.2337/dc10-1926

Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes : ACCORD trial. / Anderson, Roger T.; Narayan, K. M.Venkat; Feeney, Patricia; Goff, David; Ali, Mohammed K.; Simmons, Debra L.; Sperl-Hillen, Jo Ann; Bigger, Thomas; Cuddihy, Robert; O'Conner, Patrick J.; Sood, Ajay; Zhang, Ping; Sullivan, Mark D.

In: Diabetes Care, Vol. 34, No. 4, 01.04.2011, p. 807-812.

Research output: Contribution to journalArticle

Anderson, RT, Narayan, KMV, Feeney, P, Goff, D, Ali, MK, Simmons, DL, Sperl-Hillen, JA, Bigger, T, Cuddihy, R, O'Conner, PJ, Sood, A, Zhang, P & Sullivan, MD 2011, 'Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes: ACCORD trial', Diabetes Care, vol. 34, no. 4, pp. 807-812. https://doi.org/10.2337/dc10-1926
Anderson RT, Narayan KMV, Feeney P, Goff D, Ali MK, Simmons DL et al. Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes: ACCORD trial. Diabetes Care. 2011 Apr 1;34(4):807-812. https://doi.org/10.2337/dc10-1926
Anderson, Roger T. ; Narayan, K. M.Venkat ; Feeney, Patricia ; Goff, David ; Ali, Mohammed K. ; Simmons, Debra L. ; Sperl-Hillen, Jo Ann ; Bigger, Thomas ; Cuddihy, Robert ; O'Conner, Patrick J. ; Sood, Ajay ; Zhang, Ping ; Sullivan, Mark D. / Effect of intensive glycemic lowering on health-related quality of life in type 2 diabetes : ACCORD trial. In: Diabetes Care. 2011 ; Vol. 34, No. 4. pp. 807-812.
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AU - Goff, David

AU - Ali, Mohammed K.

AU - Simmons, Debra L.

AU - Sperl-Hillen, Jo Ann

AU - Bigger, Thomas

AU - Cuddihy, Robert

AU - O'Conner, Patrick J.

AU - Sood, Ajay

AU - Zhang, Ping

AU - Sullivan, Mark D.

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N2 - OBJECTIVE - To compare the effect of intensive versus standard glycemic control strategies on health-related quality of life (HRQL) in a substudy of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. RESEARCH DESIGN AND METHODS - A randomly selected subsample of 2,053 ACCORD participants enrolled in the HRQL substudy was assessed at baseline and 12-, 36-, and 48-month visits. HRQL assessment included general health status (the 36-Item Short Form Health Survey [SF-36]), diabetes symptoms (the Diabetes Symptom Distress Checklist), depression (Patient Health Questionnaire [PHQ]-9), and treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire [DTSQ]). Repeated-measures ANOVA models were used to estimate change in HRQL outcomes by treatment group over 48 months adjusting for model covariates. The effects of early discontinuation of the ACCORD intensive glycemic control arm on study results were explored. RESULTS-A total of 1,956 (95%) completed the self-report HRQL instrument(s) at baseline. The intensive arm had a larger decrease in SF-36 physical health component score than the standard arm (-1.6 vs. -1.1, P = 0.0345). Treatment satisfaction (DTSQ) showed larger improvement with intensive than standard (P = 0.0004). There were no differences in mean scores of the Diabetes Symptom Checklist and PHQ-9. Effects of participant transition following discontinuation of the intensive arm on HRQL were not significant. CONCLUSIONS - The ACCORD trial strategy of intensive glycemic control did not lead to benefits in HRQL and was associated with modest improvement in diabetes treatment satisfaction. Thus patient acceptability was apparently not compromised with intensive and complex interventions such as those used in ACCORD.

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