Beyond Glycaemia

Socioeconomic Factors and Diabetes Distress are Associated with Health-Related Quality of Life in People with Type 2 Diabetes

Abstract

Background. Diabetes is a complex multifactorial disease. Therapy focused only on managing glycaemia does not yield optimal health outcomes. Health-related Quality of Life (HRQOL) is a broad, subjective, and multidimensional concept gaining significance in diabetes care. The complex interplay of HRQOL and other factors must be addressed to achieve optimal health outcomes.

Objective. We aim to describe the factors associated with HRQOL in type 2 diabetes. 

Methodology. A single-center cross-sectional short messaging service (SMS) survey invited adults with type 2 diabetes (T2D) with ≥1 clinic attendance in the past year. Participants completed the Problem Areas in Diabetes-5 (PAID5), Diabetes Distress Scale-17 (DDS17), and European Quality of Life Score (EQ5D5L). Demographic and diabetes-related data were retrieved from electronic medical records. Multiple regression models were created with EQ5D5L Index score (HRQOL) as the dependent variable.

Result. A total of 1406 people with T2D participated, 46.4% women, mean (SD) age 61.1 (13.4) years, BMI 27.1(5.4) kg/m², and HbA1c 8.0 (1.4)%. 60.9% had ≥1 microvascular and 23.8% had ≥1 macrovascular complication. Mean (SD) of EQ5D5L Index score was 0.81 (0.27), EQ5D Visual Analog Score (VAS) was 77.4 (23.8), Total mean DDS17 score was 1.87 (0.93) and PAID5 score was 5.04 (4.5). 26.9% and 11.3% had significant diabetes distress (DD) based on PAID5 ≥8 and DDS17 ≥3. Multiple regression models revealed diabetes distress, a lower class of housing type, presence of macrovascular complication, higher BMI, older age, and female sex to be associated with a poorer EQ5D5L Index Score.

Conclusion.  Multiple non-glycemic factors like sociodemographic, socioeconomic, and diabetes distress impact health-related QoL in people with type 2 diabetes.