Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil: data from the Brazilian Type 1 Diabetes Study Group

Abstract

BackgroundIn type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities.MethodsThis was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected.ResultsWe have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North-Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined.ConclusionsOur study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities.

Factors Affecting the Quality of Life and the Illness Acceptance of Pregnant Women with Diabetes

“…A higher income meant a higher HRQoL—a relationship not demonstrated in the GDM group. Surprising results indicating the contrary were reported by Felicio et al [ 37 ]. In their study, the highest HRQoL was reported by participants of low or very low economic status, with the lowest monthly incomes [ 37 ].…”

“…Surprising results indicating the contrary were reported by Felicio et al [ 37 ]. In their study, the highest HRQoL was reported by participants of low or very low economic status, with the lowest monthly incomes [ 37 ]. The authors’ own results show that the women’s average or poor financial standing correlated with worse quality of life scores in the physical, psychological, and environmental domains.…”

Difficulties concerning Diabetes Mellitus Type 1 in children and adolescents

“…The average of glucose monitoring performed by patients was 4.4 times per day. The blood glucose monitoring as is essential to the metabolic control of patients with Diabetes Mellitus type 1 and it always be guided and encouraged by the health professional educators (4) .…”

“…A person with Diabetes Mellitus Type 1 will live with the disease for longer periods of time, requiring strict metabolic control involving medication and changes in lifestyle, such as healthy eating and physical activity, in order to prevent and delay the onset of complications related to Diabetes Mellitus (4) . However, despite continued advances in knowledge, in therapy and available technology, most people with Diabetes Mellitus type 1 have unsatisfactory glycemic control (5) .…”

Assessment of health-related quality of life among adult patients with type 2 diabetes mellitus

“…Therefore, a patient's perception of his/her own quality of life is considered as a valuable basis for identifying targets for improvement [10][11][12].…”