One-third of adults with diabetes in the United States have chronic kidney disease (CKD), and 19% of them have eye complications (ECs). However, little is known about the Health-related Quality of Life (HRQoL) of adults with both of these diabetes-related complications. Therefore, the purpose of this study is to examine differences in the HRQoL, mental health, and healthcare utilization of adults with diabetes who have CKD, ECs, both or neither. A cross-sectional study design was implemented using data from multiple panels (2009–2015) of the Medical Expenditure Panel Survey. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. The HRQoL, mental health, and healthcare utilization of four mutually exclusive groups: 1) diabetes with both CKD and ECs; 2) diabetes with CKD only; 3) diabetes with ECs only, and 4) diabetes with neither CKD nor ECs were compared. In all analyses, adults with neither CKD nor ECs were the reference group. There were 8415 adults with diabetes who met the inclusion criteria. Approximately, 75% of the study sample had neither CKD nor ECs, 13.3% had ECs only, 5.7% had CKD only, and 5.5% had both CKD and ECs. In the adjusted analyses, adults with both CKD and/or ECs complications exhibited significantly lower HRQoL compared to those with neither CKD nor ECs. Mental illness and psychological distress were higher among adults with both CKD and ECs compared to those with neither CKD nor ECs. Furthermore, adults with CKD and/or ECs had higher polypharmacy, inpatient and emergency services use compared to those with neither CKD nor ECs. The results indicate that the presence of both CKD and/or ECs was negatively associated with poor HRQoL, poor mental health, higher psychological distress and healthcare utilization in adults with diabetes. The findings emphasize the need for routine assessment and treatment for diabetes-related CKD and/or ECs complications to improve the quality of care for individuals with diabetes.

中文翻译：

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在美国，糖尿病，肾脏和眼睛并发症的成年人与健康相关的生活质量和医疗保健利用率。

在美国，三分之一的糖尿病成年人患有慢性肾脏病（CKD），其中19％患有眼部并发症（EC）。但是，对于患有这两种糖尿病相关并发症的成年人的健康相关生活质量（HRQoL）知之甚少。因此，本研究的目的是检查患有CKD，EC或两者都不患的糖尿病成年人的HRQoL，心理健康和医疗保健利用方面的差异。使用医疗支出小组调查的多个小组（2009-2015年）的数据实施了横断面研究设计。HRQoL使用SF-12身体和精神成分摘要（PCS＆MCS）得分进行测量。四个互斥组的HRQoL，心理健康和医疗保健利用：1）患有CKD和EC的糖尿病；2）仅患有CKD的糖尿病；3）仅限于EC的糖尿病，4）既没有CKD也没有EC的糖尿病。在所有分析中，既没有CKD也没有EC的成年人是参考组。有8415名符合纳入标准的糖尿病成年人。大约有75％的研究样本既没有CKD，也没有EC，只有13.3％的人既没有EC，5.7％的人只有CKD，5.5％的人都没有CKD和EC。在调整后的分析中，与既没有CKD也没有EC的成年人相比，患有CKD和/或EC并发症的成年人的HRQoL显着降低。有CKD和EC的成年人比没有CKD和EC的成年人的精神疾病和心理困扰更高。此外，与没有CKD和EC的成年人相比，有CKD和/或EC的成年人具有更高的多药房，住院和急诊服务使用率。结果表明，CKD和/或ECs的存在与成人HRQoL差，心理健康差，心理困扰增加和医疗保健利用率呈负相关。研究结果强调需要对糖尿病相关的CKD和/或EC并发症进行常规评估和治疗，以提高对糖尿病患者的护理质量。