Health-related quality of life in diabetes mellitus patients in primary health care

Quality of Life and Its Determinants Among Individuals With Diabetes in Saudi Arabia: A Cross-Sectional Online Survey

Background Diabetes mellitus is a significant public health issue globally, with increasing prevalence rates. In Saudi Arabia, a substantial proportion of the adult population is affected. While the impact of diabetes on physical health is well-documented, less is known about its effects on emotional and social well-being in this region. Methods From January to March 2024, we conducted a cross-sectional online survey of 207 individuals with diabetes in Saudi Arabia. The survey, available in Arabic and English, assessed physical symptoms, emotional health, social interactions, and overall quality of life. Descriptive statistics were used for analysis. Results The majority of participants were aged 31-45 years (n=63, 30.4%) and female (n=118, 56.9%). Type 2 diabetes was the most common (n=122, 59.1%). Regarding physical health, 34.6% (n=72) rated their health as good while 37.2% (n=77) experienced physical symptoms sometimes and 17.9% (n=37) often. Emotional health challenges were reported by 39.2% (n=81) experiencing anxiety and 33.9% (n=70) experiencing depression. Social interactions were impacted, with 28.6% (n=59) reporting challenges in relationships and 14.3% (n=30) facing significant impacts on recreational activities. Overall quality of life was rated as good by 40.4% (n=83), fair by 29.9% (n=62), and very poor by 4.8% (n=10). Conclusions The study highlights the significant effects of diabetes on the physical, emotional, and social aspects of life in Saudi Arabia. The findings underscore the need for comprehensive care strategies that incorporate medical treatment, emotional support, and social integration to improve the overall quality of life for individuals with diabetes.

Diabetes quality of life, Chemical Intolerance, and generational status in a Latino sample: an RRNeT study

Objectives

The impact of diabetes on quality of life (QoL) includes deficits in physical functioning and emotional and mental health. Individuals with diabetes can experience significant distress related to diabetes management and burden. Comorbid conditions can contribute to QoL among individuals with diabetes. Chemical Intolerance (CI) has received minimal attention in the context of diabetes. CI is characterized by multi-systemic symptoms initiated by a one-time high dose or persistent low-dose exposure to environmental toxins. Latinos experience diabetes distress and are exposed to environmental factors at disproportionate rates. This study sought to investigate generational differences in diabetes QoL and CI in a Latino sample across generational status.

Methods

To assess the modifying effect of CI between QoL and generations, the analysis was stratified by those with and without CI.

Results

Compared to 2nd generation Latinos, Latino immigrants were more likely to indicate that without diabetes, their life would be better across several QoL domains. Latino immigrants had a lower A1C and BMI than2nd generation Latinos. Additionally, they were less likely to have scores indicative of CI than U.S.-born Latinos. QoL varied by generational status and suggested a greater emphasis on family and social relationships among immigrants than U.S.-born Latinos. There were no differences in health services measures across generations.

Conclusions

This study highlights generational differences in the impact of diabetes on QoL. It is one of the few studies to seek to understand the impact of CI on QoL in the context of a chronic condition such as type 2 diabetes.

Ranking of diseases affecting the health-related quality of life of patients in Poland - a cross-sectional study

Introduction

Epidemiology of non-communicable diseases (NCDs) provides scientific evidence indicating the appearance of dysfunction and disability in patients in various aspects and, as a result, a decrease in the quality of life (QoL). The main aim of the research was to prepare a ranking of diseases determining the degree of disease incidence quality of life (HRQoL) of patients in physical and mental dimensions.

Material and methods

The study was carried out in a group of 7,620 patients assigned to 13 groups of disease entities. The quality of life was assessed using the SF-36 questionnaire. The chances of a better QoL were assessed and the groups of diseases determining the individual QoL dimensions were indicated. Multi-stage, stratified random sampling was used in the study to obtain representatives in each diseases entities.

Results

The worst quality of life among the 13 analysed diseases was noted among cancer patients. Patients with ENT (ear, nose, throat) diseases had the highest chance of a better QoL among the studied subjects (Mental Component Summary (MCS)-OR: 27.4; Physical Component Summary (PCS)-OR: 27.9). Diseases such as cancers, diseases of the nervous system and cardiovascular diseases determined the lowest QoL in terms of MCS, PCS and ILQ (Index of Life Quality). Additionally, lower QoL in the MCS dimension was also affected by diabetes, diseases of the digestive and respiratory systems.

Conclusions

Cancer, cardiovascular disease and diseases of the nervous system are the disease entities correlated with poorer quality of life.

Quality of life in the course of a one-year use of an advanced hybrid closed-loop system in adults with type 1 diabetes previously naïve to advanced diabetes technology

AIM

To evaluate the effect of a one-year use of an advanced hybrid closed-loop (AHCL) system on the quality of life, level of anxiety, and level of self-efficacy in adults with type 1 diabetes (T1D) previously treated with multiple daily injections (MDI) and naïve to advanced diabetes technology.

METHODS

A total of 18 participants of a previously published 3-month randomized trial (10 men, 8 women; age 40.9 ± 7.6 years) who were switched directly from MDI/BMG to AHCL completed 12 months of MiniMed 780G™system use (a 3-month randomized trial followed by a 9-month follow-up phase). At month 6 of the study, patients were switched from the sensor GS3 (Continuous Glucose Monitoring) system, powered by Guardian™ Sensor 3) to GS4. Quality of life was assessed using the Polish validated version of the 'QoL-Q Diabetes' questionnaire. The level of anxiety was evaluated with the use of the State-Trait Anxiety Inventory (STAI). Self-efficacy was assessed with the General Self-Efficacy Scale (GSES). Results were obtained at baseline and at the end of the study.

RESULTS

Significant increase in QoL was reported in the global score (p=0.02, Cohen d=0.61) and in as many as 11 out of 23 analyzed areas of life: being physically active (p=0.02, Cohen d = 0.71); feeling well (p<.01, Cohen d = 0.73); feeling in control of my body (p<.01, Cohen d = 0.72); looking good (p<.01, Cohen d = 1.07); working (p<.01, Cohen d = 1.12); sleeping (p=0.01, Cohen d = 0.66); eating as I would like (p<.01, Cohen d = 0.79); looking after or being useful to others (p= 0.02, Cohen d = 0.65); being active with pets/animals (p<.01, Cohen d = 0.95); being spontaneous (p=0.02, Cohen d = 0.67); and doing "normal" things (p=0.02, Cohen d = 0.67). Both state (p=0.04, Cohen d = 0.56) and trait (p=0.02, Cohen d = 0.60) anxiety decreased while the general self-efficacy increased (p=0.03, Cohen d = 0.76). No participant stopped the use of the pump.

CONCLUSION

Adult patients with T1D previously treated with MDI and naïve to modern technologies experienced significant improvement in their psychological well-being after transitioning to the AHCL system after 12 months of treatment.

The Impact of Diabetes Mellitus Duration and Complications on Health-Related Quality of Life Among Type 2 Diabetic Patients in Khamis Mushit City, Saudi Arabia

BACKGROUND AND OBJECTIVES

 Diabetes mellitus is one of the most significant public health problems in Saudi Arabia. Therefore, this study aims to investigate the impact of disease duration and disease complications on health-related quality of life among type 2 diabetic patients.

MATERIALS AND METHODS

A cross-sectional study was conducted on 380 adult diabetic type 2 patients at a tertiary hospital in the city of Khamis Mushit in Saudi Arabia. The participants were asked to complete a pre-validated health status questionnaire (SF-36) consisting of 36 questions measuring eight domains of health, with each domain providing a score from 0 to 100. Demographic and clinical variables were collected using a diabetes type 2 specification form designed to be used in conjunction with the health status questionnaire. The clinical data included variables such as duration of diabetes, co-morbidities, and treatment modality. Statistical analysis was conducted using SPSS version 22 (IBM Corp., Armonk, NY, USA), with differences tested using various statistical tests. Spearman correlation was done between the score and continuous variables, such as age and BMI. A p-value less than 0.05 was considered statistically significant.

RESULTS

Most of the participants (40%) were recently diagnosed with diabetes mellitus (less than one year ago) and 29.5% of the participants were diagnosed with diabetes mellitus within one to five years. The percentage of those with complications was 39.2%, which was mainly diabetic foot (43.4%) followed by nephropathy (29.5%). 46.8% of the participants were admitted due to conditions related to diabetes mellitus. Dietary modifications were prescribed in 38.4% of the participants, 19.5% used non-insulin medications only, 22.6% were on insulin, and 19.5% were using oral medications and insulin. The relationship between diabetes mellitus complications and quality of life domains revealed no significant difference in most of the domains except physical function and general health, which were lower with complicated diabetes melitus. Similarly, the relation between diabetes mellitus duration and quality of life domains was also not significant in all domains except physical function, which was low with a duration of more than 10 years.

CONCLUSIONS

Understandably, the complications associated with diabetes melitus resulted in low quality of life - in terms of physical function and general health - due to the organ-dysfunction associated with poor glycaemic control. Similarly, disease duration greater than 10 years resulted in impaired physical functioning.