In a recent issue of Diabetes Care, Hill-Briggs et al. (1) found that the Medical Outcomes Study 36-item short form (SF-36) did not improve in a population whose outcome measures (HbA1c, triglycerides, and diastolic blood pressure) showed modest improvement. We found a similar lack of change in the standard SF-36 in a group of patients whose HbA1c levels, measured in a boronate affinity assay in which the upper limit of normal was 6.8%, fell >3.0% from an initial median of 11.9% (2). Hill-Briggs et al. suggested that diabetes-specific questions be either added to the SF-36 or used alone to evaluate the impact of diabetes interventions on health status and health-related quality of life. We selected the latter by including the following two diabetes-specific questions (developed by Ron Hayes, PhD, Rand Corp., Santa Monica, CA) in our study.
1) During the past months how much did your diabetes cause a problem with each of the following?
Doing things on the spur-of-the-moment
The amount of time or inconvenience involved in treating your diabetes
Maintaining a diet and preparing food
Having a large appetite for food
Feeling embarrassed in public while managing your diabetes
Taking a trip or going on vacation
Pain or discomfort involved in taking care of your diabetes
Doing things socially with friends/relatives
Planning meals or eating out with others
Your family life, getting along with others
Having to plan things differently to take care of your diabetes
Lack of interest in sex or enjoyment of sex
2) Overall, how much of a problem is it to live a normal life and take care of your diabetes?
Responses were given the following discrete scores: very much a problem (0), somewhat of a problem (33), a little bit of a problem (66), not a problem (100), and not applicable. Thus, the higher the score, the more positive the answer. These items were scored in the same manner as the standard SF-36 form. Both of them improved significantly in our population (2), validating the suggestion by Hill-Briggs et al.
