Research On Quality Of Life And Influencing Factors In Patients With Type2Diabetes Mellitus In China

Objectives:1) To evaluate health-related quality of life (HRQoL) among patientswith type2diabetes mellitus using two generic preference-based instruments, incomparison with that of general population.2) To examine the difference of HRQoLamong patients between subgroups defined by clinical characteristics and glucosecontrolling-related information.3) To explore the influencing factors of quality of lifeamong patients with type2diabetes mellitus.Methods: A face-to-face interview was conducted from July,2011to December,2011. Patients with type2diabetes mellitus were recruited from a community inBeijing and a tertiary hospital in Tianjian, while general population were recruitedfrom Physical Examination Center of a tertiary hospital in Tianjin. The questionnaireincluded five contents: demographic information, life style information, quality of lifequestionnaire (EQ-5D, EQ-VAS and SF-6D instruments), clinical characteristics, andglucose-related information of patients. χ2test and Mann-Whitney U test wereconducted to test the differences of HRQoL between patients with type2diabetesmellitus and general population and among different subgroups defined by clinicalcharacteristics and glucose control-related information. Hierarchical multipleregression analyses were conducted to explore the factors associated with HRQoL oftype2diabetes patients, in which clinical characteristics, glucose-related information,demographic information and life style information were adopted as independentvariables.Results:1) A total of573type2diabetes patients was included with mean age of63.6(±9.87). Most patients (93.5%) had≥1complication. About64.79%，45.19%and47.31%patients had FBG,2h-BG and HbA1c control.2) Compared with generalpopulation, type2diabetes patients had significantly lower HRQoL in EQ-5D index(0.78vs.0.95, p<0.001), SF-6D utility index (0.76vs.0.88, P<0.001) and EQ-VAS(68.09vs.86.59, P<0.001). Patients reported the most severe problems inpain/discomfort and physical function dimensions, the there occurred different levelsof problems in other dimensions.3) Patients with complications and any specificcomplication had significantly lower EQ-5D score compared to those without thecorresponding complications (0.77vs.0.83, P<0.001).Patients with FBG and2h-BGcontrol had significantly higher EQ-5D score compared to those withoutcontrol(0.80vs.0.74;0.82vs.0.75.P<0.01). Similar results were observed for SF-6D andEQ-VAS scores in these subgroups.4) Hierarchical multiple linear regression results showed diabetes patients’ clinical characteristics, demographic and life styleinformation variables had significant influence on EQ-5D, SF-6D and EQ-VASscores, especially clinical characteristics had the strongest impact on HRQoL, amongwhich hypertension, cerebrovascular disease, retinopathy, nephropathy, peripheralvascular diseases, neuropathy and body mass index may exert significant influence onat least1dependent variable, respectively. Exercise and sleep were also significantlyassociated with HRQoL.Conclusions: Compared to general population, patients with type2diabetes mellitushave poorer quality of life, physical dimension was worstly impaired, psychologicaland social dimension were also impaired. Clinical characteristics were signigicantlyassociated with quality of life, clinical physicians should pay more attention onimprovement of patients’ clinical condition. Better exercise habit and sleep qualitymay lead to better HRQoL, patients should develop good life style inself-management to improve the HRQoL of type2diabetes mellitus patients.