Gender Differences in Contributions of Mutable and Immutable Factors on Quality of Life in Adults with Type 2 Diabetes

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Background: The aim of this study was to assess contributions of mutable and immutable factors on quality of life (QoL) in men and women with type 2 diabetes. Methods: Cross-sectional study of 615 adults from two clinics in the southeastern U.S. Hierarchical models were performed for the full sample, women, and men using the physical component score (PCS) and mental component score (MCS) of QoL as dependent variables, adjusting for sociodemographic, socioeconomic, psychosocial, built environment, clinical, and self-care factors and diabetes knowledge. Results: For women, significant associations were found between PCS QoL and neighborhood aesthetics (β=0.09; p=0.009) and exercise environment (β=-0.03; p=0.010), accounting for 25% of the variance and MCS QoL and serious psychological distress (SPD) (β=-0.12; p=0.001), perceived health status, (β=-0.54; p=0.040) and diabetes knowledge (β=0.11; p=0.046), accounting for 36% of the variance. For men, significant associations were seen between PCS QoL and SPD (β=0.02; p=0.031), neighborhood crime (β=-0.17; p=0.041), neighborhood comparison (β=0.17; p=0.012), and kidney problems (β=0.25; p=0.045), accounting for 12% of the variance and MCS QoL and depression (β=-0.08; p=0.004), SPD (β=-0.07; p=0.002), perceived stress (β=-0.14; p=0.001) diabetes duration (β=0.03; p=0.015), comorbidity (β=-0.15; p=0.014), and perceived health status (β=-0.28; p=0.045), accounting for 51% of the variance. Conclusions: Significant associations were observed between QoL and mutable factors, suggesting areas amenable to health interventions. For women, interventions should focus on improving the built environment, decreasing SPD, and improving diabetes knowledge. For men, interventions should focus on the built environment, mental health, and comorbid conditions. Disclosure J.S. Williams: None. L.E. Egede: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. Advisory Panel; Self; Novo Nordisk Inc..