Quality-of-Life Determinants in People with Diabetes Mellitus in Europe.

Álvaro Fuentes-Merlos,Jose A Quesada Rico,Raul Reina,Domingo Orozco-Beltrán

doi:10.3390/ijerph18136929

Abstract

This study aims to analyze self-perceived health and lifestyles in the European Union Member States Iceland, Norway, and the United Kingdom, examining associations with diabetes prevalence; and to identify the demographic, economic and health variables associated with diabetes in this population. We performed a cross-sectional study of 312,172 people aged 15 years and over (150,656 men and 161,516 women), using data collected from the European Health Interview Survey (EHIS). The EHIS includes questions on the health status and health determinants of the adult population, as well as health care use and accessibility. To estimate the magnitudes of the associations with diabetes prevalence, we fitted multivariate logistic models. The EHIS data revealed a prevalence of diabetes in Europe of 6.5% (n = 17,029). Diabetes was associated with being physically inactive (OR 1.14; 95% CI 1.02–1.28), obese (OR 2.75; 95% CI 2.60–2.90), male (OR 1.46; 95% CI 1.40–1.53) and 65–74 years old (OR 3.47; 95% CI 3.09–3.89); and having long-standing health problems (OR 7.39; 95% CI, 6.85–7.97). These results were consistent in the bivariate and multivariate analyses, with an area under the receiver operating characteristic curve of 0.87 (95% CI 0.87–0.88). In a large European health survey, diabetes was clearly associated with a poorer perceived quality of life, physical inactivity, obesity, and other comorbidities, as well as non-modifiable factors such as older age and male sex.

Highlights

Improvements in health interventions are defined in terms of their efficacy and, less frequently, their efficiency [1]
We aim to analyze self-perceived health and lifestyles in the European Union Member States Iceland, Norway, and the United Kingdom, examining associations with diabetes prevalence; and to identify the demographic, economic and health variables associated with diabetes in this population
Other factors associated with diabetes prevalence were male sex, older age and higher number of comorbidities, such as myocardial infarction, hypertension, cirrhosis, kidney problems

Summary

Introduction

Improvements in health interventions are defined in terms of their efficacy and, less frequently, their efficiency [1]. Innovative health strategies such as the Triple Aim framework adopt a multifactorial approach to health intervention assessment, analyzing efficacy and cost (efficiency), while incorporating patients’ perspectives. The ageing of the European population calls for new strategies to assess the association of lifestyles and various socio-demographic variables with chronic diseases [2,3]. Patients can suffer acute complications (e.g., hypoglycemia or ketoacidosis) as well as long-term microvascular complications (e.g., retinopathy, neuropathy, or nephropathy) or macrovascular disease (e.g., stroke or heart disease), all of which result in greater disability (i.e., limitation of activities of daily living) and an enormous financial burden for European health systems [2]

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