TOPLINE:

Among adults with type 1 diabetes (T1D), an increase in the severity of diabetes-related complications was associated with a decrease in health-related quality of life, with the inverse association holding across most dimensions except for anxiety and depression, freedom to drink, and freedom to eat.

METHODOLOGY:

• This cross-sectional analysis used data of 1892 adults with T1D in France (median age, 38 years; 52% men) to evaluate health-related quality of life in this population and its relationship with the severity of diabetes-related complications.
• Health-related quality of life was determined using two self-reported questionnaires: the generic EuroQol 5-Dimensions 5-Level (EQ-5D-5L) and the diabetes-specific Audit of Diabetes-Dependent Quality of Life (ADDQOL).
• The EQ-5D-5L questionnaire captured participants' health status across five dimensions: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression.
• The ADDQOL questionnaire assessed the effect of diabetes on overall health-related quality of life and specific life domains.
• The burden of complications across organ systems was quantified using the Diabetes Complications Severity Index (DCSI), where higher scores indicated more severe complications.

TAKEAWAY:

• The mean overall health-related quality-of-life score on EQ-5D-5L was 71.1 out of 100, and the median DCSI score was 1.
• Impairments were reported in mobility (14%), self-care (5%), usual activities (19%), pain and discomfort (45%), and anxiety and depression (52%).
• Each 1-point increase in the DCSI score was associated with a 1.5% decrease in the global EQ-5D-5L score after adjusting for confounders (P < .001); this inverse association was seen across domains except for anxiety and depression.
• Among 1375 ADDQOL respondents, each 1-point increase in the DCSI score was linked to a 0.9% decrease in overall health-related quality of life (P < .001); scores on most domains worsened with a higher complication burden, except for freedom to eat and freedom to drink.

IN PRACTICE:

"This [study] highlights the impact of complications on different aspects of the lives of pwT1D [people living with T1D] and reinforces the importance of preventing complications to maintain quality of life," the authors wrote.

SOURCE:

The study was led by Sara Barraud, MD, CRESTIC, Service d'Endocrinologie Diabete Nutrition, URCA, CHU de Reims, Reims, France. It was published online on December 02, 2025, in Diabetes, Obesity and Metabolism.

LIMITATIONS:

The findings came from a French cohort with its own demographics and health system, which may have limited generalisability. The study relied on self-reported data, which could have introduced response bias. It used the DCSI, a tool not widely used in T1D-only studies. The cross-sectional design precluded establishing a cause and effect relationship between complications and quality of life.

DISCLOSURES:

The study was supported by multiple sources, including the Foundation Francophone pour la Recherche sur le Diabète, the Société Francophone du Diabète, and the Luxembourg Institute of Health. Some authors reported receiving grants or contracts, consulting fees, payments or honoraria for lectures and participation on speakers' bureau, and support for attending meetings and/or travel as well as declared having other ties with various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.