Screening Oropharyngeal Dysphagia in Diabetic Patients and Its Potential Impact on Quality of Life

Abstract

Background: Diabetes mellitus is a common chronic disease that affects the entire body, but some of its complications are less recognized. There are underlying mechanisms that suggest a possible co-occurrence of oropharyngeal dysphagia with diabetes. Objectives: The primary goal of this study was to assess the symptoms of oropharyngeal dysphagia resulting from diabetes and explore potential relationships between oropharyngeal dysphagia, sex, age, duration of diabetes, and types of interventions. Additionally, we aimed to investigate how dysphagia might impact the quality of life of individuals with diabetes mellitus. Methods: A total of 268 diabetic patients aged 18 - 65 years participated in this recent cross-sectional study. Participants were specifically selected from individuals with type 2 diabetes mellitus based on inclusion criteria. We collected brief medical histories and demographic information from each patient. Following the medical history, patients were questioned about their swallowing condition, and self-reported signs of dysphagia were recorded. Patients were also asked to complete a Persian version of the Dysphagia Handicap Index (P-DHI) questionnaire, which is used to assess dysphagic patients' self-assessments. Swallowing function was evaluated using the Mann Assessment of Swallowing Ability (MASA) test. Statistical analyses were performed using SPSS version 16, and Pearson and Spearman correlation coefficients were employed to assess relationships among variables. Results: Our findings revealed that women experienced more severe dysphagia compared to men. Furthermore, the impact of dysphagia on the quality of life was more significant among individuals treated with insulin than among diabetic patients not on insulin therapy (P-value = 0.001). Conversely, there was no significant difference in the quality of life among individuals with varying levels of education (P-value = 0.069). The most commonly reported symptom by patients on the self-report survey was "food sticking to the throat during swallowing." Additionally, patients faced considerable difficulties with the dry mouth subscale of P-DHI and the voice subscale of MASA. Conclusions: Our results suggest that patients with diabetes may exhibit various symptoms of oropharyngeal dysphagia. Detecting different signs of dysphagia associated with diabetes can guide researchers in developing new screening tools for dysphagia in these patients. Furthermore, our study identified relationships between various variables, aiding therapists in predicting potential signs of dysphagia. For instance, we found a relationship between the duration of diabetes and the occurrence of dysphagia, which can assist therapists in predicting dysphagia in patients with a longer history of diabetes.