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 (PAID-5), Diabetes Distress Scale-17 (DDS17), and European Quality of Life Score (EQ-5D-5L). Demographic and diabetes-related data were retrieved from electronic medical records. Multiple regression models were created with EQ-5D-5L 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)%. Of these, 60.9% had ≥1 microvascular and 23.8% had ≥1 macrovascular complication. Mean (SD) of EQ-5D-5L 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 PAID-5 score was 5.04 (4.5). 26.9% and 11.3% had significant diabetes distress (DD) based on PAID-5 ≥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 EQ-5D-5L Index Score.

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