Diabetes Metab J.  2011 Dec;35(6):587-594. 10.4093/dmj.2011.35.6.587.

The Relationship between Diabetes Mellitus and Health-Related Quality of Life in Korean Adults: The Fourth Korea National Health and Nutrition Examination Survey (2007-2009)

  • 1Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea. djkim@ajou.ac.kr
  • 2Division of Endocrinology, Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.


Diabetes is a major health problem in Korea. However, interest in the quality of life in patients with diabetes is low. We examined the effects of diabetes on health-related quality of life (HRQoL) and compared it with HRQoL in the general Korean population using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009).
Using KNHANES IV data, we compared EuroQol (EQ)-5D and EQ-visual analogue scale (VAS) scores after adjusting for sociodemographic and psychosocial factors as well as for comorbidities (hypertension, heart disease, stroke, arthritis, and chronic renal disease). Logistic regressions were used to explore determinants for the lowest quintile HRQoL scales in the diabetes group.
The mean age of the 14,441 enrolled subjects (6,129 men and 8,312 women) was 52.5+/-14.5 years. The mean EQ-5D and EQ-VAS scores were significantly lower in the diabetes group (EQ-5D. 0.87; EQ-VAS, 71.94) than in the non-diabetes group (EQ-5D, 0.94; EQ-VAS, 77.40) (P<0.001). Self-reported depressive symptom had a significant effect on lowering the EQ-VAS (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1 to 2.6) in the diabetes group. Stress level had a significant effect in lowering both the EQ-5D (OR, 2.0; 95% CI, 1.3 to 2.9) and the EQ-VAS (OR, 1.9; 95% CI, 1.3 to 2.9). HbA1c, diabetes duration, and treatment modalities had no significant effect on lowering HRQoL.
Diabetes was clearly associated with impaired HRQoL compared with the non-diabetic population regardless of comorbidities. Therapeutic approaches should focus much more on the subjective perception of health in patients with diabetes.


Diabetes; EQ-5D; Health-related quality of life; Korea National Health and Nutrition Examination Survey

MeSH Terms

Diabetes Mellitus
Heart Diseases
Logistic Models
Nutrition Surveys
Quality of Life
Weights and Measures


  • Fig. 1 Distribution of perceived problem levels in each of the dimensions of the EQ-5D descriptive system for the diabetes (DM) and non-DM groups. aSignificance level between with and without diabetes by chi-square test.

  • Fig. 2 Multi-variables adjusted means of (A) EQ-5D scores and (B) EQ-visual analogue scale (VAS) according to chronic diseases; diabetes (DM), hypertension (HTN), heart diseases, stroke, and chronic renal failure (CRF). aSignificant difference between those with and without the chronic disease (P<0.05).

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