Health-Related Quality of Life and Associated Factors Among Adults with Type-2 Diabetes Mellitus: A Community-Based Cross-Sectional Study in Rural Kerala, India.

Background: India is the second-largest country in the world with an estimated 77 million people living with diabetes. Persons with diabetes reported lower quality of life when compared to non-diabetes persons. There are significant associations between poor health-related quality of life (HRQoL) and adverse health outcomes among diabetes people. However, evidence documenting the same in India is scarce.

Aims: To assess the health-related quality of life and its determinants among diabetic patients in rural Kerala, India.

Methods: We conducted a community-based cross-sectional study among 425 adults type-2 diabetic patients from rural Kerala. The World Health Organization Quality of Life questionnaire was used to measure HRQoL. Multiple logistic regression analysis was used to study the association between HRQoL and independent variables.

Results: More than half of the respondents were men (52%), and 45% were older adults (≥60 years). Poor quality of life was reported by 38% of the respondents. Medium [Odds ratio (OR):4.70, 95%CI: 2.61-8.46] and low socio-economic status (SES) group (OR: 4.59, CI: 2.43-8.66) had poorer HRQoL compared to the higher SES group. Those with multi-morbidity (OR: 2.91, CI: 1.63-5.19), unemployed (OR: 2.54, CI: 1.46-4.42), and less educated (OR: 2.28, CI: 1.34-3.88) and older adults (OR: 2.11, CI: 1.28-3.45) were more likely to have poor HRQoL compared to their counterparts.

Conclusion: More than one-third of the diabetes patients in rural Kerala reported poor HRQoL. The study also identified age, socio-economic status, education, and occupation as the important predictors of HRQoL among diabetes patients. The findings highlighted the need for assessing HRQoL as part of the routine management of diabetes care in similar settings.