Abstract
BackgroundType 2 diabetes mellitus (DM2) is a chronic disease, and for treatment to succeed, it is necessary to harmonize the mental health of the patient with the environment, which impacts quality of life and adherence to medical regimens. The objetive of this study is describe the quality of life of patients with DM2 and the factors relates to its modification.MethodsThis investigation was a cross-sectional study. Patients over 18 years of age with DM2 were selected. The following variables related to quality of life were studied: age, sex, occupation, marital status, years of DM2 evolution, comorbidities and presence of depression (Beck Depression Inventory). Perceived quality of life was measured with a health-related quality of life (HRQoL) scale, the 36-Item Short-Form Survey (SF-36). Patients were classified according to SF-36 HRQoL score (< 50, 51-75 and > 76 points).ResultsAmong the 1394 patients included, the median age was 62 years. Global HRQoL had a median of 50.1 points. Bivariate analysis showed that age, marital status, sex, occupation, comorbidities, duration of DM2 and comorbidities had impacts on HRQoL. The logistic regression model identified age (odds ratio [OR] 1.04) and depression (OR 4.4) as independent factors that influenced overall quality of life.ConclusionsPatients with DM2 have poor HRQoL, which is associated with a high frequency of depression. Older age and the presence of depression impair patient HRQoL.Trial registrationR-2013-781-052. Registered 20 December 2014.
Highlights
Type 2 diabetes mellitus (DM2) is a chronic disease, and for treatment to succeed, it is necessary to harmonize the mental health of the patient with the environment, which impacts quality of life and adherence to medical regimens
The cohort included all consecutive outpatients who were over 18 years old and diagnosed with DM2, as defined by the criteria of the American Diabetes Association (ADA); patients were selected from five hospitals belonging to the Mexican Institute of Social Security (IMSS) in different cities in Mexico (Tampico, Ciudad Juárez, La Paz, Torreón and Ciudad Lerdo) [21]
Based on the results described with Zhang et al [19], who analyzed multiple factors associated with the quality of life (QoL) in subjects with DM2, including age, sex, marital status, duration of the disease, comorbidities and depression, all these variables impacted the QoL; depression presented the smallest difference in proportions,; before this, the sample size was calculated by a difference of proportions with an alpha of 5% and a power of 80%, leaving a total of 334 subjects per group, i.e., with and without depression
Summary
Type 2 diabetes mellitus (DM2) is a chronic disease, and for treatment to succeed, it is necessary to harmonize the mental health of the patient with the environment, which impacts quality of life and adherence to medical regimens. In Mexico, according to the National Health Survey of 2012, there has been a significant increase in the Complications lead to increased numbers of medical appointments and hospitalizations, which affect patient quality of life (QoL) and increase the burden of hospital care costs. Microvascular complications include neuropathy, retinopathy and nephropathy [9], as well as diabetic foot syndrome [10]. These complications have an emotional and physical impact on affected individuals with DM2, causing alterations in personal and family well-being. Because of the chronic nature of the disease and the difficulty in controlling it, DM can affect mood and self-esteem, generating frustration and symptoms linked to depression; restrictions on food and comorbidities in sexual life can lead to conflicts and contribute negatively to the QoL of the patient [11, 12]
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