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.

Department of Dermatology and Venereology and Copenhagen Wound Healing Centre Bispebjerg University Hospital Copenhagen Denmark

Department of Endocrinology and Nutrition Hospital de Sant Pau Autonomous University of Barcelona Barcelona Spain

Department of Endocrinology University Medical Centre Ljubljana Slovenia

Department of Endocrinology University of Malmö Malmö Sweden

Department of Surgery Twenteborg Ziekenhuis Almelo The Netherlands

Diabetes Centre Institute for Clinical and Experimental Medicine Prague Czech Republic

Diabetes Centre Tameside General Hospital Ashton under Lyne UK

Diabetic Department Kings College Hospital London UK

Division of Endocrinology Department of Internal Medicine and Research School CAPHRI Maastricht University Medical Centre Maastricht The Netherlands

H Familie Ziekenhuis and Centre de Santé des Fagnes Department of Endocrinology Rumst and Chimay Belgium

IDF Consultative Section and International Working Group on the Diabetic Foot Heemstede The Netherlands

Innere Abteilung Mariannen Hospital Werl Germany

Mathias Spital Diabetic Department Rheine Germany

Policlinico Tor Vergata Department of Internal Medicine Rome Italy

Sezione Dipartimentale Piede Diabetico Dipartimento di Area Medica Azienda Ospedaliero Universitaria Pisana Pisa Italy

The Research Unit for General Practice and Section of General Practice Department of Public Health University of Copenhagen Copenhagen Denmark

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