Health-related quality of life in diabetes mellitus and its social, demographic and clinical determinants: A nationwide cross-sectional survey.

Abstract

To investigate health-related quality of life in a representative sample of adults with diabetes mellitus in Spain, as well as its clinical and sociodemographic determinants. Diabetes mellitus is a chronic disease causing considerable morbidity and mortality worldwide, resulting in an impaired quality of life in affected people. A nationwide cross-sectional study, based on an online survey and carried out between February-March 2016, was performed on diabetic subjects recruited through diabetic patients' organisations. A validated Spanish-language version of the self-administered Diabetes Quality of Life questionnaire was used, with 0 being the worst and 100 the best QoL level. Determinant factors of health-related quality of life were assessed with the aid of multivariate analysis to control for confounding factors. The responses provided by 456 patients (52.4% being women) revealed an overall mean score of 66.4±13.3. Social/vocational worries and diabetes-related worries were the dimensions with the highest (74.3±20.1) and lowest (61.1±20.6) scores, respectively. Younger age, female gender, having no studies and poor glycaemic control were all independent determinants for an impaired overall health-related quality of life, with most of these factors having a higher impact than the dimensions negative impact of therapy on daily life, satisfaction with therapy and diabetes-related worries. Married (or equivalent) subjects had better scores in the diabetes-related worries dimension. The perception of health-related quality of life progressively worsens as glycaemic control deteriorates and with an increased number of disease complications. Most of the associations did not vary significantly with the type of diabetes mellitus. Overall health-related quality of life perception in the Spanish diabetic population is moderate and depends on several sociodemographic factors. Adequate glycaemic control to avoid disease complications improves perception. The results can help health professionals to develop strategies to promote diabetic patient self-care, in order to improve the metabolic control of the disease and avoid its complications, as a therapeutic goal towards an improvement in health-related quality of life perception.