Cent Eur J Public Health 2018, 26(2):104-110 | DOI: 10.21101/cejph.a5022

Impact of socio-demographic characteristics and long-term complications on quality of life in patients with diabetes mellitus

Miodrag Stojanović1,2, Goran Cvetanović3, Marija Anđelković Apostolović1,2, Dijana Stojanović1, Nataša Rančić1,4
1 University of Niš, Faculty of Medicine Niš, Niš, Serbia
2 Department of Biostatistics, Institute for Public Health, Niš, Serbia
3 General Hospital of Leskovac, Leskovac, Serbia
4 Centre for Control and Prevention of Diseases, Institute of Public Health, Niš, Serbia

Objective: Diabetes mellitus (DM) has been one of the leading chronic diseases worldwide over past decades. The objective of the study was to identify predictors associated with health-related quality of life (HRQOL) in diabetic patients.

Methods: A cross-sectional questionnaire-based study was conducted at the General Hospital of the city of Leskovac, between June and November 2015. The Short Form-36 (SF-36) questionnaire, EuroQol-5D (EQ-5D) and EuroQol-VAS (EQ-VAS) questionnaires were used. Univariate and multivariate linear regression analyses were performed.

Results: The total number of patients was 285, 112 men (39.3%) and 173 women (60.7%), average age 63.92 ± 1.07 years. The results of multiple linear regression of socio-demographic characteristics in relation to dimensions of the quality of life measured by SF-36 and EQ-VAS showed that age, country (rural) life, low level of education, retirement, and poor economic status are predictors of lower quality of life. Our results showed that employment has a significant association with higher Physical Component Score (PCS), Mental Component Score (MCS) and EQ-VAS score, which can be explained with higher incomes, improved economic status and less possibility for the occurrence of depressive mood. Patients without formal education have lower QOL. Univariate multiple regression analysis of the presence of micro- and macrovascular complications of DM showed that angina pectoris, heart failure, diabetic retinopathy, and diabetic nephropathy are the most important factors affecting the quality of life in our population. After including the multivariate model, all tested complications remained statistically significant.

Conclusion: Our results showed that both socioeconomic and chronic complications are relevant factors of HRQOL in type 1 and 2 diabetes mellitus patients. Age, rural lifestyle, retirement, lower level of education and low socioeconomic status, as well as DM complications (angina pectoris, hearth failure, diabetes nephropathy, and diabetes retinopathy) were found to be independent risk factors for the component scores of SF-36 and EQ-VAS score. Taking into consideration the results obtained, health practitioners should be aware not only of the clinical parameters of patients with DM, but also of their educational level and working status.

Keywords: diabetes mellitus, health-related quality of life, complications, SF-36, EuroQol-5D, EuroQol-VAS

Received: December 28, 2016; Revised: May 14, 2018; Accepted: May 14, 2018; Published: June 30, 2018  Show citation

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Stojanović M, Cvetanović G, Anđelković Apostolović M, Stojanović D, Rančić N. Impact of socio-demographic characteristics and long-term complications on quality of life in patients with diabetes mellitus. Cent Eur J Public Health. 2018;26(2):104-110. doi: 10.21101/cejph.a5022. PubMed PMID: 30102498.
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References

  1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-53. Go to original source... Go to PubMed...
  2. Currie CJ, Peyrot M, Morgan CL, Poole CD, Jenkins-Jones S, Rubin RR, et al. The impact of treatment noncompliance on mortality in people with type 2 diabetes. Diabetes Care. 2012 Jun;35(6):1279-84. Go to original source... Go to PubMed...
  3. Saito I, Inami F, Ikebe T, Moriwaki C, Tsubakimoto A, Yonemasu K, et al. Impact of diabetes on health-related quality of life in a population study in Japan. Diabetes Res Clin Pract. 2006 Jul;73(1):51-7. Go to original source... Go to PubMed...
  4. Scollan-Koliopoulos M, Bleich D, Rapp KJ, Wong P, Hofmann CJ, Raghuwanshi M. Health-related quality of life, disease severity, and anticipated trajectory of diabetes. Diabetes Educ. 2013 Jan-Feb;39(1):83-91. Go to original source... Go to PubMed...
  5. Oguntibeju OO, Odunaiya N, Oladipo B, Truter EJ. Health behaviour and quality of life of patients with type 2 diabetes attending selected hospitals in south western Nigeria. West Indian Med J. 2012 Sep;61(6):619-26. Go to PubMed...
  6. Zanuso S, Balducci S, Jimenez A. Physical activity, a key factor to quality of life in type 2 diabetic patients. Diabetes Metab Res Rev. 2009 Sep;25 Suppl 1:S24-8. Go to original source... Go to PubMed...
  7. Wong CK, Lo YY, Wong WH, Fung CS. The associations of body mass index with physical and mental aspects of health-related quality of life in Chinese patients with type 2 diabetes mellitus: results from a cross-sectional survey. Health Qual Life Outcom. 2013 Aug 21;11:142. doi: 10.1186/1477-7525-11-142. Go to original source... Go to PubMed...
  8. Bourdel-Marchasson I, Druet C, Helmer C, Eschwege E, Lecomte P, Le-Goff M, et al. Correlates of health-related quality of life in French people with type 2 diabetes. Diabetes Res Clin Pract. 2013 Aug;101(2):226-35. Go to original source... Go to PubMed...
  9. Ali MK, Feeney P, Hire D, Simmons DL, O'Connor PJ, Ganz-Lord F, et al. Glycaemia and correlates of patient-reported outcomes in ACCORD trial participants. Diabet Med. 2012 Jul;29(7):e67-74. Go to original source... Go to PubMed...
  10. Aguilar D, Solomon SD, Kober L, Rouleau JL, Skali H, McMurray JJ, et al. Newly diagnosed and previously known diabetes mellitus and 1-year outcomes of acute myocardial infarction: the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. Circulation. 2004 Sep 21;110(12):1572-8. Go to original source... Go to PubMed...
  11. Zimbudzi E, Lo C, Ranasinha S, Gallagher M, Fulcher G, Kerr PG, et al. Predictors of health-related quality of life in patients with co-morbid diabetes and chronic kidney disease. PloS One. 2016;11(12):e0168491. doi: 10.1371/journal.pone.0168491. Go to original source... Go to PubMed...
  12. Pedras S, Carvalho R, Pereira Mda G. Sociodemographic and clinical characteristics of patients with diabetic foot ulcer. Rev Assoc Med Brasil (1992). 2016 Apr;62(2):171-8. Go to original source... Go to PubMed...
  13. Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract. 2000 Feb;47(2):123-8. Go to original source... Go to PubMed...
  14. Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World J Diabetes. 2017 Apr 15;8(4):120-9. Go to original source... Go to PubMed...
  15. Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ. 1993 May 29;306(6890):1440-4. Go to original source... Go to PubMed...
  16. Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011 Dec;20(10):1727-36. Go to original source... Go to PubMed...
  17. Feng Y, Parkin D, Devlin NJ. Assessing the performance of the EQ-VAS in the NHS PROMs programme. Qual Life Res. 2014 Apr;23(3):977-89. Go to original source... Go to PubMed...
  18. Lee WJ, Song KH, Noh JH, Choi YJ, Jo MW. Health-related quality of life using the EuroQol 5D questionnaire in Korean patients with type 2 diabetes. J Korean Med Sci. 2012 Mar;27(3):255-60.
  19. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001 Jul;33(5):337-43. Go to original source... Go to PubMed...
  20. Bierman AS, Dunn JR. Swimming upstream. Access, health outcomes, and the social determinants of health. J Gen Intern Med. 2006 Jan;21(1):99-100. Go to original source... Go to PubMed...
  21. Walker RJ, Gebregziabher M, Martin-Harris B, Egede LE. Independent effects of socioeconomic and psychological social determinants of health on self-care and outcomes in Type 2 diabetes. Gen Hosp Psychiatry. 2014 Nov-Dec;36(6):662-8. Go to original source... Go to PubMed...
  22. Joensen LE, Almdal TP, Willaing I. Type 1 diabetes and living without a partner: psychological and social aspects, self-management behaviour, and glycaemic control. Diabetes Res Clin Pract. 2013 Sep;101(3):278-85. Go to original source... Go to PubMed...
  23. Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care. 2002 Mar;25(3):458-63.
  24. American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003 Dec;26(12):3333-41. Go to original source... Go to PubMed...
  25. Rasekaba TM, Graco M, Risteski C, Jasper A, Berlowitz DJ, Hawthorne G, et al. Impact of a diabetes disease management program on diabetes control and patient quality of life. Popul Health Manag. 2012 Feb;15(1):12-9. Go to original source... Go to PubMed...
  26. Quah JH, Luo N, Ng WY, How CH, Tay EG. Health-related quality of life is associated with diabetic complications, but not with short-term diabetic control in primary care. Ann Acad Med Singapore. 2011 Jun;40(6):276-86. Go to original source...
  27. Jacobson AM, Braffett BH, Cleary PA, Gubitosi-Klug RA, Larkin ME. The long-term effects of type 1 diabetes treatment and complications on health-related quality of life: a 23-year follow-up of the Diabetes Control and Complications/Epidemiology of Diabetes Interventions and Complications cohort. Diabetes Care. 2013 Oct;36(10):3131-8. Go to original source... Go to PubMed...
  28. Lloyd A, Sawyer W, Hopkinson P. Impact of long-term complications on quality of life in patients with type 2 diabetes not using insulin. Value Health. 2001 Sep-Oct;4(5):392-400. Go to original source... Go to PubMed...