Health-related quality of life among patients with type 2 diabetes mellitus using EuroQol five-dimension five level: A cross-sectional study from an urban health training center, Coimbatore, India.

Abstract

Background: Diabetes mellitus significantly impacts health-related quality of life (HRQoL). Data from urban primary care settings in South India remain limited. This study assessed HRQoL among type 2 diabetes mellitus (T2DM) patients and identified demographic and clinical determinants associated with EuroQol five-dimension five level (EQ-5D-5L) index and EQ visual analogue scale (EQ-VAS) scores.

Materials and methods: A hospital-based cross-sectional study was conducted (April-July 2025) at the urban health training center (UHTC), Coimbatore, Tamil Nadu, India. A total of 279 T2DM patients (aged ≥18 years) were enrolled using consecutive sampling. HRQoL was assessed using the licensed Tamil and English EQ-5D-5L questionnaire. Data were analyzed using R software; Chi-square tests and independent t-tests were applied (P < 0.05).

Results: Mean EQ-5D-5L index was 0.63 ± 0.37 and EQ-VAS was 72.6 ± 18.0. Pain/discomfort (52.1%) and anxiety/depression (43.2%) were the most affected dimensions. Microvascular complications (neuropathy P = 0.001; nephropathy P = 0.001; retinopathy P = 0.003), longer disease duration (P = 0.001), hospitalization (P = 0.001), and lower income (P = 0.003) were significantly associated with poorer HRQoL.

Conclusion: Pain/discomfort and psychological distress are the most impaired HRQoL domains in urban South Indian T2DM patients. Microvascular complications, longer disease duration, hospitalization, and lower socioeconomic status are key determinants. These findings support integrating HRQoL monitoring within primary care non-communicable diseases (NCD) programmers under the National Programmed for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) framework.