Diabetic complications do not hamper improvement of health-related quality of life over the course of treatment of diabetic foot ulcers - the Eurodiale study

Volkert Siersma*, Hanne Thorsen, Per E. Holstein, Marleen Kars, Jan Apelqvist, Edward B. Jude, Alberto Piaggesi, Karel Bakker, Michael Edmonds, Alexandra Jirkovska, Didac Mauricio, Heinrich Reike, Maximilian Spraul, Luigi Uccioli, Vilma Urbancic, Kristien van Acker, Jeff van Baal, Nicolaas C. Schaper

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Aims: Diabetic complications, and in particular diabetic foot ulcers (DFUs), are associated with low health-related quality of life (HRQoL). We evaluated whether the presence of diabetic complications also influenced the improvement of HRQoL during DFU treatment.

Methods: 1088 patients presenting for DFU treatment at the centers participating in the Eurodiale study were followed prospectively up to one year. HRQoL was measured both at presentation and after healing or at end of follow up, using EQ-5D: a standardized instrument consisting of five domains and a summary index. The influence of diabetic comorbidity on the course of HRQoL was evaluated for each of the EQ-5D outcomes in multi-level linear regression analyses, adjusting for baseline characteristics.

Results: HRQoL improved in all EQ-5D outcomes over the course of treatment for those DFUs that healed. The few significant differences in the development of HRQoL between patients with and without comorbidity showed a more beneficial development for patients with comorbidity in DFUs that did not heal or healed slowly.

Conclusions: Comorbidity does not hamper improvement of HRQoL in DFU treatment. On the contrary, HRQoL improved sometimes more in patients with certain comorbidity with hard-to-heal ulcers. (C) 2017 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)1145-1151
Number of pages7
JournalJournal of Diabetes and Its Complications
Issue number7
Publication statusPublished - Jul 2017


  • Diabetes mellitus
  • Health-related quality of life
  • Diabetic foot ulcer
  • Comorbidity
  • Longitudinal study
  • CARE

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