Health related quality of life in patients with type 2 diabetes mellitus in Iran: a national survey.
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ABSTRACT:
SUBMITTER: Javanbakht M
PROVIDER: S-EPMC3431351 | biostudies-other | 2012
REPOSITORIES: biostudies-other
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Project description:BackgroundAssessing the health-related quality of life in patients with type 2 diabetes mellitus is important for evaluation of treatment outcome. The purpose of this study was to evaluate the health-related quality of life in type 2 diabetes mellitus patients and its related factors in Yazd.MethodsData were gathered by using the EuroQoL-five-dimension-5 level instrument as well as using medical records of 734 outpatients with type 2 diabetes mellitus who were referred to the largest governmental diabetes center in South of Iran, Yazd province. When appropriate, the Kruskal-Wallis test or the Wilcoxon test was used to test the difference in the health-related quality-of-life scores in each factor. Finally, the adjusted limited dependent variable mixture model was developed to investigate factors associated with health-related quality-of-life scores.ResultsThe mean and median of the EuroQoL-five-dimension-5 level index values of 717 patients who completed the questionnaires were 0.75 ± 0.006 and 0.72 ± 0.20, respectively, and those of the Visual Analogue Scale scores were 69.25 ± 0.63 and 75 ± 30, respectively. The mean scores for health-related quality of life were significantly higher for employed, educated, single, and male patients, as well as patients without comorbidities, diabetes-related complications, and hemoglobin A1c level >7%. Adjusted limited dependent variable mixture model showed that gender, age, marital status, and diabetes-related complications are significant independent predictors of EuroQoL-five-dimension-5 level index value.ConclusionThe mean scores for health-related quality of life in patients with type 2 diabetes mellitus were moderate in this study, and this finding is consistent with health-related quality-of-life scores reported in other studies conducted in the Middle East region. Therefore, health-related quality of life should be the most important consideration in the management of patients. In parallel, some factors, especially gender, should be considered to improve health-related quality of life.
| S-EPMC8107944 | biostudies-literature
Project description:ObjectiveWe examined whether adiposity and fitness explain the decrease in health-related quality of life (HRQOL) associated with type 2 diabetes mellitus.MethodsThis was a cross-sectional study using baseline data from two exercise training interventions. One study enrolled people with and the other without type 2 diabetes. We assessed aerobic fitness ("fitness") as peak oxygen uptake during treadmill testing, adiposity ("fatness") as percentage of total body fat by dual-energy x-ray absorptiometry, and HRQOL by the Medical Outcomes Study SF-36. Bivariate and multivariate linear regression analyses were used examine determinants of HRQOL were used to examine determinants of HRQOL.ResultsThere were 98 participants with and 119 participants without type 2 diabetes. Participants with type 2 diabetes had a mean hemoglobin A1c of 6.6% and, compared with participants without diabetes had lower HRQOL on the physical component summary score (P = 0.004), role-physical (P = 0.035), vitality (P = 0.062) and general health (P < 0.001) scales after adjusting for age, sex and race. These associations of HRQOL with type 2 diabetes were attenuated by higher fitness, even more than reduced fatness. Only general health remained positively associated with type 2 diabetes after accounting for fatness or fitness (P = 0.003). There were no significant differences between participants with and without diabetes in the mental component score.ConclusionImproved fitness, even more than reduced fatness, attenuated the association of type 2 diabetes with HRQOL. The potential to improve HRQOL may motivate patients with type 2 diabetes to engage in physical activity aimed at increasing fitness. Findings from this cross-sectional analysis will be addressed in the ongoing trial of exercise training in this cohort of participants with type 2 diabetes.Trial registrationNCT00212303.
| S-EPMC2626587 | biostudies-literature
Project description:BackgroundEvidence for the association between social determinants of health (SDoH) and health-related quality of life (HRQoL) is largely based on single SDoH measures, with limited evaluation of cumulative social disadvantage. We examined the association between cumulative social disadvantage and the Health and Activity Limitation Index (HALex).MethodsUsing adult data from the National Health Interview Survey (2013-2017), we created a cumulative disadvantage index by aggregating 47 deprivations across 6 SDoH domains. Respondents were ranked using cumulative SDoH index quartiles (SDoH-Q1 to Q4), with higher quartile groups being more disadvantaged. We used two-part models for continuous HALex scores and logistic regression for poor HALex (< 20th percentile score) to examine HALex differences associated with cumulative disadvantage. Lower HALex scores implied poorer HRQoL performance.ResultsThe study sample included 156,182 respondents, representing 232.8 million adults in the United States (mean age 46 years; 51.7% women). The mean HALex score was 0.85 and 17.7% had poor HALex. Higher SDoH quartile groups had poorer HALex performance (lower scores and increased prevalence of poor HALex). A unit increase in SDoH index was associated with - 0.010 (95% CI [-0.011, -0.010]) difference in HALex score and 20% higher odds of poor HALex (odds ratio, OR = 1.20; 95% CI [1.19, 1.21]). Relative to SDoH-Q1, SDoH-Q4 was associated with HALex score difference of -0.086 (95% CI [-0.089, -0.083]) and OR = 5.32 (95% CI [4.97, 5.70]) for poor HALex. Despite a higher burden of cumulative social disadvantage, Hispanics had a weaker SDoH-HALex association than their non-Hispanic White counterparts.ConclusionsCumulative social disadvantage was associated with poorer HALex performance in an incremental fashion. Innovations to incorporate SDoH-screening tools into clinical decision systems must continue in order to accurately identify socially vulnerable groups in need of both clinical risk mitigation and social support. To maximize health returns, policies can be tailored through community partnerships to address systemic barriers that exist within distinct sociodemographic groups, as well as demographic differences in health perception and healthcare experience.
| S-EPMC10476290 | biostudies-literature
Project description:BACKGROUND:Polyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients. OBJECTIVES:To describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017. METHODS:An institution based cross sectional study with internal comparison was conducted among a sample of 220 type II diabetes mellitus patients in a 1:1 matched ratio of those with and without diabetes associated peripheral neuropathic pain. All were having regular follow up at two hospitals in Addis Ababa, Ethiopia. The Short Form (SF-36) health-related quality of life instrument was used to collect data on quality of life while basic socio-demographic and other disease specific features were collected using a structured questionnaire. Descriptive statistics was used to examine the mean scores of health related quality of life. Cronbach's alpha coefficient and Pearson's correlation coefficient were applied to estimate the internal consistency, and the level of agreement between the different domains of SF-36, respectively. To measure association between health related quality of life domains and explanatory variables, independent T-test and ANOVA were performed followed by multiple linear regression analyses. RESULTS:The health related quality of life of type II diabetes mellitus patients with peripheral neuropathic pain was poorer than those without pain in all the eight domains and the two summary scores by SF-36 (p < 0.001). Higher mean score difference was observed in Mental Component Summary Score (MCS) (14.6) compared to Physical Component Score (PCS) (9.3). Among the eight domains, the largest mean difference was found with the physical one (39.1) followed by mental health (38.2) and physical functioning (30). Pain intensity had a statistically significant negative correlation with all domains as well as the two summary scores. Younger age, a higher level of education, being single, a higher monthly income, normal body mass index, HbA1c less than seven mmo/L, absence of other diabetic complications and taking only oral hypoglycemic agents were found to predict better health related quality of life. CONCLUSION:The presence of diabetic peripheral neuropathic pain was found to negatively influence the health-related quality of life of type II diabetic patients; the greatest impact being on the 'role physical' and 'mental health' domains. Older age, presence of diabetes related complications, longer duration of illness negatively influenced the health-related quality of life.
| S-EPMC6361436 | biostudies-literature
Project description:BackgroundDiabetes is accompanied by a marked reduction in patient's quality of life (QOL) and leads to higher disability-adjusted life years than most diseases. Depression further deteriorates QOL and is associated with poor treatment outcomes and lowered glycemic control in diabetes. We analysed the QOL and depression among the people living with diabetes in Nepal.MethodsWe conducted a cross-sectional survey among a random sample of 157 diabetic patients visiting diabetes clinic at a major teaching hospital in Kathmandu, Nepal. We administered the Nepali version of WHO-BREF for face to face interviews to obtain data on QOL scores. The Nepali version of Patient Health Questionnaire-9was also used to record responses on depression items.ResultsMore than half of the respondents (54.1%) experienced depression with mean PHQ-9 score of 6.15 ± 5.01 on a scale of 0-27. On a scale of 0 to 100, highest QOL mean score was reported in social relationship domain (57.32 ± 11.83), followed by environment domain (54.71 ± 7.74), psychological health (53.25 ± 10.32) and physical health (50.74 ± 11.83). After adjusting for other covariates, urban residence decreased the physical health score by 4.74 (? = -4.74, 95% CI: -8.664,-0.821), social relationship domain score by 3.420 (? = -3.420, 95% CI: -6.433,-0.406) and the overall QOL by 2.773 (? = -2.773, 95% CI: -5.295,-0.252). Having diagnosed with diabetes since more than 10 years increased physical health by 5.184 score points (? = 5.184; 95% CI: 0.753, 9.615).Similarly, having severe depression decreased social relation domain score by 6.053 (? = -6.053, 95% CI:-11.169,-.936).ConclusionHaving urban residence significantly decreased the physical health and social relation domain scores as well as the overall QOL scores. Similarly, having diagnosed since more than 10 years increased physical health domain score. Severe depression decreased social relationship domain score. Since depression affects QOL, we suggest early diagnosis and prompt treatment of depression in T2DM people as part of their routine primary care in Nepal.
| S-EPMC4658137 | biostudies-literature
Project description:PurposeTo assess health-related quality of life (HRQOL) of subjects at risk of type 2 diabetes undergoing lifestyle intervention, and predictors for improved HRQOL.MethodsThe Finnish Diabetes Risk Score was used by general practitioners to identify individuals at risk. Low-intensity interventions with an 18-month follow-up were employed. HRQOL was assessed using the SF-36 at baseline and compared with results from a general Norwegian population survey and further at 6 and 18 months. Simple and multiple linear regression analyses were applied to identify predictors of changes in HRQOL of clinical importance.ResultsTwo hundred and thirteen participants (50 % women; mean age: 46 years, mean body mass index: 37) were included: 182 returned for 18-month follow-up, of whom 172 completed the HRQOL questionnaire. HRQOL was reduced with clinical significance compared with general Norwegians. The mean changes in HRQOL from the baseline to the follow-up were not of clinical importance. However, one out of three individuals achieved a moderate or large clinical improvement in HRQOL. The best determinant for improved HRQOL was obtained for a composite, clinically significant lifestyle change, i.e. both a weight reduction of at least 5 % and an improvement in exercise capacity of at least 10 %, which was associated with an improvement in five out of the eight SF-36 domains.ConclusionSubjects at risk of type 2 diabetes report a clinically important reduction in HRQOL compared with general Norwegians. The best predictor of improved HRQOL was a small weight loss combined with a small improvement in aerobic capacity.
| S-EPMC4186973 | biostudies-literature
Project description:BackgroundThe characteristics and risk factors of post-COVID-19 condition affecting health-related quality of life and the symptom burden are unclear.MethodsThe present, cross-sectional study used the JASTIS (Japan Society and New Tobacco Internet Survey) database. EQ-5D-5L and Somatic Symptom Scale-8 were used to assess health-related quality of life and somatic symptoms, respectively. The participants were classified into a no-COVID-19, COVID-19 not requiring oxygen therapy or COVID-19 requiring oxygen therapy group. First, the entire cohort was analyzed. Then, sensitivity analysis was performed after excluding patients in the no-COVID-19 group with a history of close contact with individuals known to have the disease.FindingsIn total, 30130 individuals (mean age: 47.8; females: 51.2%), including 539 and 805 with COVID-19 requiring and not requiring oxygen therapy, respectively, participated. The analysis of the entire cohort as well as the sensitivity analysis demonstrated that individuals with a history of COVID-19 had significantly lower EQ-5D-5L and significantly higher SSS-8 scores than those with no COVID-19 history. The group requiring oxygen therapy was associated with significantly lower EQ-5D-5L and higher SSS-8 scores than the group not requiring oxygen therapy. Propensity-score matching confirmed these results. Furthermore, two or more COVID-19 vaccinations were independently associated with high EQ-5D-5L and low SSS-8 scores (P < 0.001).ConclusionsThe participants with a COVID-19 history, especially those with severe disease, had a significantly higher somatic symptom burden. Analysis after adjusting for potential confounders found that their quality-of-life was also severely affected. Vaccination is crucial to addressing these symptoms, especially in high-risk patients.
| S-EPMC10140465 | biostudies-literature
Project description:The objective of this study was to investigate the association between ethnicity and health related quality of life (HRQoL) in patients with type 2 diabetes.The EuroQol EQ-5D measure was administered to 1,978 patients with type 2 diabetes in the UK Asian Diabetes Study (UKADS): 1,486 of south Asian origin (Indian, Pakistani, Bangladeshi or other south Asian) and 492 of white European origin. Multivariate regression using ordinary least square (OLS), Tobit, fractional logit and Censored Least Absolutes Deviations estimators was used to estimate the impact of ethnicity on both visual analogue scale (VAS) and utility scores for the EuroQol EQ-5D.Mean EQ-5D VAS and utility scores were lower among south Asians with diabetes compared to the white European population; the unadjusted effect on the mean EQ-5D VAS score was -7.82 (Standard error [SE]?=?1.06, p?<?0.01) and on the EQ-5D utility score was -0.06 (SE?=?0.02, p?<?0.01) (OLS estimator). After controlling for socio-demographic and clinical confounders, the adjusted effect on the EQ-5D VAS score was -9.35 (SE?=?2.46, p?<?0.01) and on the EQ-5D utility score was 0.06 (SE?=?0.04), although the latter was not statistically significant.There was a large and statistically significant association between south Asian ethnicity and lower EQ-5D VAS scores. In contrast, there was no significant difference in EQ-5D utility scores between the south Asian and white European sub-groups. Further research is needed to explain the differences in effects on subjective EQ-5D VAS scores and population-weighted EQ-5D utility scores in this context.
| S-EPMC4060842 | biostudies-other
Project description:Diabetes mellitus has reached epidemic levels, and it threatens the economy and health globally and Saudi Arabia in particular. The study assessed health-related quality of life using EuroQol instrument and its predictors among patients with Type 2 diabetes mellitus in Eastern Province, Saudi Arabia. A cross-sectional study was conducted among 378 patients with Type 2 diabetes mellitus from two major health centers in Eastern Province. The study showed moderate health-related quality of life, as reported by the median index score of 0.808 with more than a quarter of patients with severe-extreme health state in some or all domains. Multiple-regression models showed that male gender, high monthly income, having no diabetes-related complications and having random blood glucose level less than 200 mg/dl were prone to have a higher index score compared to the corresponding contrary groups. The study will help in guiding the development of effective intervention programs to improve diabetes-related health-related quality of life among the Saudi population.
| S-EPMC6953887 | biostudies-literature
Project description:Generic, preference-based measures of health-related quality of life (HRQoL) are a common input to the economic evaluation of new health technologies. As such, it is important to explore what characteristics of patients with Type 1 diabetes might impact scores on such measures.This study utilizes baseline data from a cluster-randomized trial that recruited patients with Type 1 diabetes at six centers across Ireland. Health-related quality of life was assessed using the three-level EuroQol EQ-5D (EQ-5D) measure. Patients' responses to individual dimensions of the EQ-5D were explored. To see which patient factors influenced EQ-5D scores, multivariate regression analysis was conducted with EQ-5D scores as the outcome variable.Data was available for 437 Type 1 diabetes patients. The median age of these patients was 40 (IQR: 31-49) years and 53.8% were female. Overall, patients reported a high HRQoL based on EQ-5D scores (0.87 (SD: 0.19). Fifty-four percent of patients reported a perfect HRQoL. For those that reported problems, the most common dimension was the anxiety/depression dimension of the EQ-5D (29.6%). In the multivariate regression analysis, self-reported mental illness (-?0.22 (95% CI: -0.34, -?0.10)) and being unemployed (-?0.07 (95% CI: -0.13, -?0.02)) were negatively associated with EQ-5D scores (p?<?0.05). The influence of self-reported mental illness was persistent in sensitivity analyses.The study results indicate that patients with Type 1 diabetes report a high HRQoL based on responses to the EQ-5D. However, there are a substantial number of Type 1 diabetes patients that report problems in the anxiety/depression dimension, which may provide avenues to improve patients' HRQoL.Current Controlled Trials ISRCTN79759174 .
| S-EPMC5797407 | biostudies-literature