Abstract
ObjectiveElderly patients with type 2 diabetes mellitus are highly vulnerable due to severe complications. However, there is a contradiction in the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed the quality of life and its interfering factors in this patient population.MethodsIn total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang Province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data.ResultsThe average quality of life score was − 29.25 ± 24.41. Poorly scored domains of quality of life were “Psychological feeling” (− 8.67), “Activity” (− 6.36), and “Emotion” (− 6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (1) directly (c′ = 0.6831); (2) indirectly through self-management behavior (a1*b1 = 0.1773); and (3) indirectly through FPG control (a2*b2 = 0.1929). Self-management behavior influenced the quality of life directly and indirectly through FPG control.ConclusionImproving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to the elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.
Highlights
The incidence of type 2 diabetes mellitus has been overgrowing due to lifestyle changes, urbanization, and aging
Patients with low to moderate social support and poor self-management behavior had the lowest quality of life scores, followed by those with fasting plasma glucose (FPG) > 16.7 mmol/L and those who never engaged in physical exercise
In conclusion, this study explored the underlying mechanisms between social support and quality of life among Chinese elderly patients with diabetes, which contributed to deepening the theoretical research on the quality of life by extending social support/self-management application to the quality of life
Summary
The incidence of type 2 diabetes mellitus has been overgrowing due to lifestyle changes, urbanization, and aging. Qi et al Health and Quality of Life Outcomes (2021) 19:254 the global prevalence of adult diabetes has increased dramatically from 4.7% in 1980 to 9.0% in 2014 [3] and 9.5% in 2019 [4]. In China, the percentages of adult patients with diabetes has increased from 0.67% in 1979, to 2.7% in 2002, to 11.6% in 2010 [5, 6], to 10.9% in 2013 [7], to 11.2–12.8% in 2017 [8, 9], and 10.9% in 2019 [10]. The proportion of elderly patients with type 2 diabetes mellitus in China has increased dramatically from 10.2% in 2000 to 13.6% in 2006, 20.4% in 2007, 22.86% in 2010 [5, 6, 14], 34.1% in 2017 [15], and 35.5% in 2019 [10], which indicates a severe public health issue. As important as biomedical markers, the quality of life of elderly patients with type 2 diabetes mellitus should receive more attention and prioritized care from medical staff and society [18]
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