Vision-related quality of life and locus of control in type 1 diabetes: a multicenter observational study

Marina Trento*, Lorena Charrier, Franco Cavallo, Stefania Bertello, Salvatore Oleandri, Maria Carla Donati, Salvatore Rizzo, Gianni Virgili, Giuseppe Picca, Francesco Bandello, Rosangela Lattanzio, Elena Aragona, Roberto Perilli, Stefano Casati, Elena Beltramo, Aurora Mazzeo, Paolo Fornengo, Olga Durando, Stefano Merlo, Massimo Porta

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Aims: Diabetic retinopathy remains asymptomatic until its late stages but remains a leading cause of vision impairment and blindness. We studied quality of life and the ability to deal with the discomfort deriving from the presence of a chronic disease in patients with type 1 diabetes and different stages of retinopathy. Methods: Multicenter collaborative observational study involving nine centers screening for retinopathy in different areas of Italy. The National Eye Institute 25-item visual functioning questionnaire and the locus of control tool were administered to 449 people with type 1 diabetes between February 2016 and March 2018. Socio-demographic and clinical data were collected. Results: On multivariable analysis, severe retinopathy is associated with worse scores for general vision, ocular pain, near vision activities, distance vision activities, driving, color vision, peripheral vision and lower values of internal control, independently of visual acuity. Women had a perception of worse general health, distance vision activities and driving, and lower internal control and trust in others. Worse scores for visual-specific social functioning, visual-specific mental health, visual-specific role difficulties, visual-specific dependency and peripheral vision were associated with higher HbA1c levels. Fatalism increased with rising HbA1c levels. Conclusions: These results confirm that a gap exists between patients’ knowledge and expectations on retinopathy and providers’ expertise and assumptions. To bridge this gap, patient-centered education and engaging approaches may be more effective than simple information given during consultations.

Original languageEnglish
Pages (from-to)1209-1216
Number of pages8
JournalActa Diabetologica
Issue number11
Early online date17 Jul 2019
Publication statusPublished - 01 Nov 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019, Springer-Verlag Italia S.r.l., part of Springer Nature.

Copyright 2019 Elsevier B.V., All rights reserved.


  • Diabetic retinopathy
  • People with type 1 diabetes
  • Quality of life

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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