Ten-year trends in self-rated health among Spanish adults with diabetes, 1993 2003.

OBJECTIVE Improving health-related quality of life among individuals with diabetes is a public health goal. This study sought to assess trends in self-rated "fair" and "poor" health among Spanish adults with diabetes and to identify factors associated with fair and poor health using data from all five National Health Surveys conducted from 1993 to 2003. RESEARCH DESIGN AND METHODS Poisson regression analysis was used to assess the trend in fair or poor health status during the period 1993-2003 and to compare prevalences between diabetes and nondiabetes sufferers. RESULTS The most relevant finding of this study is that, among Spanish adults with diabetes, prevalence of fair or poor heath is more than double that of individuals without diabetes and that overall prevalence did not vary during the decade 1993-2003 (71.2 to 70.5%). The variables associated with an increased risk of self-rated fair or poor health were as follows: age 54-64 years (odds ratio [OR] 1.5) or >or= 65years (2.1), presence of comorbidity (4.3), female sex (1.2), lower educational level (1.7), obesity (1.3), and no physical activity (1.6). CONCLUSIONS The lack of improvement in self-rated health among Spanish adults with diabetes calls for urgent implementation of health-promotion, prevention, and diabetes-management strategies aimed at enhancing the quality of life of such individuals.