Abstract
Objective: Diabetes is associated with impaired health-related quality of life (HRQoL) which predicts adverse clinical outcome. To examine clinical factors associated with HRQoL in a cross-sectional cohort of 14,826 Hong Kong Chinese patients with type 2 diabetes receiving outpatient care. Methods: Adult patients with type 2 diabetes who underwent comprehensive assessment of risk factors and complications using the web-based Joint Asia Diabetes Evaluation (JADE) Program also completed the EuroQol-5D (EQ-5D) questionnaire and visual analogue scale (VAS) for evaluation of HRQoL. Multiple linear regression analysis was used to identify clinical correlates with EQ-5D index and the association was expressed using β-coefficient whereby β>0 indicates positive correlation and β<0 indicates negative correlation. Results: More patients reported problems with pain/discomfort (24.8%) and anxiety/depression (20.3%) than other dimensions of mobility (7.1%), self-care (2.2%) and usual activities (4.3%). Age (β=-0.001), female gender (β=- 0.049), obesity (β=-0.007), hypoglycemia at least once monthly (β=-0.04), presence of cardiovascular disease (β=- 0.034), nephropathy (β=-0.014) and sensory neuropathy (β=-0.063) were independently correlated with lower EQ-5D index, while hypertension (β=0.017) and use of insulin (β=0.017) were correlated with higher EQ-5D index (p<0.05). Conclusion: In Hong Kong Chinese patients with type 2 diabetes, somatic and psychological complaints were common. Apart from demographic characteristics, risk factors, complications and treatment all influenced HRQoL.
Highlights
The prevalence of diabetes is rising globally and it is estimated that over 60% of people with diabetes reside in Asia [1]
In Chinese patients with type 2 diabetes, low body mass index (BMI), use of insulin, young age and hypoglycemia had been associated with poor health-related quality of life (HRQoL) [8] while physical activity was protective [9]
We further examined the association of clinical factors with overall HRQoL as expressed by the EQ-5D index and visual analogue scale (VAS) using multiple linear regression with the backward elimination procedure
Summary
The prevalence of diabetes is rising globally and it is estimated that over 60% of people with diabetes reside in Asia [1]. Relative to the general population, people affected by diabetes consistently reported diminished health-related quality of life (HRQoL) [3,4,5]. Despite the growing epidemic of diabetes in Asia, there is a relative paucity of data pertaining to HRQoL in these populations. Despite the importance of HRQoL, both as an encompassing self-perceived measure of health and a possible prognostic predictor, its assessment is frequently overlooked in clinical practice. In this cross-sectional study, we used EuroQol-5D (EQ-5D) to evaluate HRQoL and identify the clinical correlates with EQ-5D in Hong Kong patients with type 2 diabetes receiving outpatient care
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