Diabetes Metab J.  2014 Jun;38(3):220-229. 10.4093/dmj.2014.38.3.220.

Factors Associated with Health-Related Quality of Life among Saudi Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Survey

• Al Hayek A
• Robert AA
• Al Saeed A
• Alzaid AA
• Al Sabaan

• KMID: 2280693
• DOI: http://doi.org/10.4093/dmj.2014.38.3.220

Abstract

BACKGROUND
Diabetes mellitus (DM) is associated with high mortality, morbidity, poor general health, and loss of health-related quality of life (HRQOL). The objective of the study was to assess the factors associated with HRQOL among patients with type 2 diabetes mellitus (T2DM).
METHODS
This was a cross sectional study conducted among 283 T2DM patients during June 2011 and September 2012 at a major tertiary hospital in Riyadh, Saudi Arabia. The respondents were purposively and conveniently selected according to their availability during their routine visit to the outpatient clinics and they were interviewed using the Arabic version of the Short-Form 36-item survey (SF-36) to assess the HRQOL.
RESULTS
The mean age of the participants was 56.4+/-13.2 years. Around 63% (178) were males and 37% (105) were females. Glycosylated hemoglobin level was found to be significantly higher among female and HRQOL was higher among male. Respondents who were more than 50 years old had poor HRQOL than less than 50 years age group. Poor economic status, reported diabetic complications and longer duration of diabetes were significantly associated with poor HRQOL. The respondents treated with combination of therapies (oral medication plus insulin) indicated better HRQOL than patients with insulin therapy alone. Multivariate analysis indicated that gender, economic status (except subscale energy), and complications of DM (except subscale energy) as independent risk factor for HRQOL.
CONCLUSION
Gender, economic status, and complication of DM were independent risk factors for majority of the subscales of HRQOL.

Keyword

Anxiety; Diabetes mellitus; Quality of life; Saudi Arabia

MeSH Terms

Ambulatory Care Facilities
Anxiety
Arabs
Cross-Sectional Studies*
Surveys and Questionnaires
Diabetes Complications
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Female
Hemoglobin A, Glycosylated
Humans
Insulin
Male
Mortality
Multivariate Analysis
Quality of Life*
Risk Factors
Saudi Arabia
Tertiary Care Centers
Insulin

Reference

1. Agarwal S, Raman R, Paul PG, Rani PK, Uthra S, Gayathree R, McCarty C, Kumaramanickavel G, Sharma T. Sankara nethralaya-diabetic retinopathy epidemiology and molecular genetic study (SN-DREAMS 1): study design and research methodology. Ophthalmic Epidemiol. 2005; 12:143–153.

2. Cong JY, Zhao Y, Xu QY, Zhong CD, Xing QL. Health-related quality of life among Tianjin Chinese patients with type 2 diabetes: a cross-sectional survey. Nurs Health Sci. 2012; 14:528–534.

3. Scollan-Koliopoulos M, Bleich D, Rapp KJ, Wong P, Hofmann CJ, Raghuwanshi M. Health-related quality of life, disease severity, and anticipated trajectory of diabetes. Diabetes Educ. 2013; 39:83–91.

4. Daniele TM, Bruin VM, Oliveira DS, Pompeu CM, Forti AC. Associations among physical activity, comorbidities, depressive symptoms and health-related quality of life in type 2 diabetes. Arq Bras Endocrinol Metabol. 2013; 57:44–50.

5. Egede LE, Hernandez-Tejada MA. Effect of comorbid depression on quality of life in adults with type 2 diabetes. Expert Rev Pharmacoecon Outcomes Res. 2013; 13:83–91.

6. Alzaid A. Diabetes: a tale of two cultures. Br J Diabetes Vasc Dis. 2012; 12:57.

7. Al-Hayek AA, Robert AA, Alzaid AA, Nusair HM, Zbaidi NS, Al-Eithan MH, Sam AE. Association between diabetes self-care, medication adherence, anxiety, depression, and glycemic control in type 2 diabetes. Saudi Med J. 2012; 33:681–683.

8. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27:1047–1053.

9. Camacho F, Anderson RT, Bell RA, Goff DC Jr, Duren-Winfield V, Doss DD, Balkrishnan R. Investigating correlates of health related quality of life in a low-income sample of patients with diabetes. Qual Life Res. 2002; 11:783–796.

10. Genovese S, Tedeschi D. Effects of vildagliptin/metformin therapy on patient-reported outcomes: work productivity, patient satisfaction, and resource utilization. Adv Ther. 2013; 30:152–164.

11. Oguntibeju OO, Odunaiya N, Oladipo B, Truter EJ. Health behaviour and quality of life of patients with type 2 diabetes attending selected hospitals in south western Nigeria. West Indian Med J. 2012; 61:619–626.

12. Myers VH, McVay MA, Brashear MM, Johannsen NM, Swift DL, Kramer K, Harris MN, Johnson WD, Earnest CP, Church TS. Exercise training and quality of life in individuals with type 2 diabetes: a randomized controlled trial. Diabetes Care. 2013; 36:1884–1890.

13. Mikailiukstiene A, Juozulynas A, Narkauskaite L, Zagminas K, Salyga J, Stukas R. Quality of life in relation to social and disease factors in patients with type 2 diabetes in Lithuania. Med Sci Monit. 2013; 19:165–174.

14. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67:361–370.

15. Al Abdulmohsin SA, Coons S, Draugalis JR, Hays RD. Translation of the RAND 36-item health survey 1.0 (aka SF-36) into Arabic. Santa Monica: Rand;1997.

16. Hays RD, Shapiro MF. An overview of generic health-related quality of life measures for HIV research. Qual Life Res. 1992; 1:91–97.

17. Al-Nuaim AR, Mirdad S, Al-Rubeaan K, Al-Mazrou Y, Al-Attas O, Al-Daghari N. Pattern and factors associated with glycemic control of Saudi diabetic patients. Ann Saudi Med. 1998; 18:109–112.

18. Imam K. Management and treatment of diabetes mellitus. Adv Exp Med Biol. 2012; 771:356–380.

19. Unden AL, Elofsson S, Andreasson A, Hillered E, Eriksson I, Brismar K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gend Med. 2008; 5:162–180.

20. Song SH. Emerging type 2 diabetes in young adults. Adv Exp Med Biol. 2012; 771:51–61.

21. Hanninen J, Takala J, Keinanen-Kiukaanniemi S. Quality of life in NIDDM patients assessed with the SF-20 questionnaire. Diabetes Res Clin Pract. 1998; 42:17–27.

22. Al-Maskari MY, Al-Shookri AO, Al-Adawi SH, Lin KG. Assessment of quality of life in patients with type 2 diabetes mellitus in Oman. Saudi Med J. 2011; 32:1285–1290.

23. Grant JF, Hicks N, Taylor AW, Chittleborough CR, Phillips PJ. North West Adelaide Health Study Team. Gender-specific epidemiology of diabetes: a representative cross-sectional study. Int J Equity Health. 2009; 8:6.

24. Eljedi A, Mikolajczyk RT, Kraemer A, Laaser U. Health-related quality of life in diabetic patients and controls without diabetes in refugee camps in the Gaza strip: a cross-sectional study. BMC Public Health. 2006; 6:268.

25. Wubben DP, Porterfield D. Health-related quality of life among North Carolina adults with diabetes mellitus. N C Med J. 2005; 66:179–185.

26. Glasgow RE, Ruggiero L, Eakin EG, Dryfoos J, Chobanian L. Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care. 1997; 20:562–567.

27. Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care. 2002; 25:458–463.

28. Bradley C, Todd C, Gorton T, Symonds E, Martin A, Plowright R. The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: the ADDQoL. Qual Life Res. 1999; 8:79–91.

29. Holmanova E, Ziakova K. Audit diabetes-dependent quality of life questionnaire: usefulness in diabetes self-management education in the Slovak population. J Clin Nurs. 2009; 18:1276–1286.

30. Dinneen SF, Gerstein HC. The association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus. A systematic overview of the literature. Arch Intern Med. 1997; 157:1413–1418.

31. American Diabetes Association. Detection and management of lipid disorders in diabetes. Diabetes Care. 1993; 16:828–834.

32. Lloyd A, Sawyer W, Hopkinson P. Impact of long-term complications on quality of life in patients with type 2 diabetes not using insulin. Value Health. 2001; 4:392–400.

33. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998; 352:837–853.

34. UK Prospective Diabetes Study 6. Complications in newly diagnosed type 2 diabetic patients and their association with different clinical and biochemical risk factors. Diabetes Res. 1990; 13:1–11.

35. Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care. 1992; 15:815–819.