Predictors of Health-Related Quality of Life Among Patients with Type II Diabetes Mellitus Who Are Insulin Users: A Multidimensional Model

Abstract

Background Diabetes Mellitus is a progressive, chronic and multifactorial endocrine disorder characterized by elevated serum glucose levels. It has a direct effect to social and health related quality of life. Objective This study aimed to determine the health-related quality of life among patients with type II diabetes mellitus (T2DM) using insulin therapy. Methods Cross-sectional observational study design was used to collect data from Malaysian patients with T2DM. Subjective and objective assessments were made either by using several questionnaires or each patient's specific medication profile registered to care sites. Study participants were recruited from both public hospitals and community health clinics located in Kuala Lumpur, Malaysia. Results A total of 430 patients with T2DM were recruited in this study with a response rate of 94.7%. The oral antidiabetic medication (OAM) group consisted of 63.0% of the study population and the rest (37.0%) were Insulin users. The body mass index and glycosylated hemoglobin patterns were significantly different between groups ( P < 0.011 and P < 0.001). Insulin users showed high percentages of healthy body mass index index (44.7%) compared with OAM users (35.8%) and controlled glycemic index (glycosylated hemoglobin ≤7.5%) was significantly ( P = 0.001) better among the insulin-user group compared with the OAM group. The Euro Quality of Life–5 dimension domain analysis indicated significant differences with domains of usual work ( P < 0.047), pain and discomfort ( P < 0.041), and anxiety and depression ( P < 0.001) among insulin users versus OAM users. We also observed a significant difference between the groups regarding diet, monitoring, and disease-specific knowledge. The mean (SD) adherence score showed that insulin users were significantly ( P < 0.001) more adherent (6.09 [2.98]) than OAM were nonadherent (4.19 [4.68]). Conclusions This study suggests the valuable effect of insulin therapy among patients with T2DM compared with OAMs on health-related quality of life, medication adherence, and health state. Insulin users reported they had better diabetes-related knowledge and treatment adherence characteristics than noninsulin users.

Health-related quality of life and associated factors among patients with type II diabetes mellitus: A study in the family medicine center (FMC) of Agricultural General Hospital in Hanoi, Vietnam

“…Results from regression model indicated that those suffering from diabetes complications were more likely to report lower HRQoL. This result is in line with other recent studies in Vietnam and other countries ( Arifin et al, 2019 ; Gillani et al, 2019 ; Pham et al, 2020 ). These diabetes complications have the potential to add significant health and finance burdens, and have been associated with diminished HRQoL in adults ( Wexler et al, 2006 ).…”

A systematic review on clinical implication of continuous glucose monitoring in diabetes management

“…[ 2 ] The health-disease burden showed increasing trends over the past decade[ 2 ] and to improve health-related quality of life, along with diabetic care, extensive monitoring guidelines should also be implemented. [ 1 2 3 4 5 ] Literature showed dominant prevalence of type 2 diabetes mellitus (T2DM) over type 1 diabetes mellitus (T1DM) all around the world. [ 1 4 , 5 ]…”

“…[ 1 2 3 4 5 ] Literature showed dominant prevalence of type 2 diabetes mellitus (T2DM) over type 1 diabetes mellitus (T1DM) all around the world. [ 1 4 , 5 ]…”

“…[ 6 ] The effect and management outcomes based on multifactorial concept including demographic variability, disease and social functioning, and self-care behavior are the strong influencers in treatment plan. [ 4 5 ] Disease control or progression based on continuous/frequent blood glucose monitoring[ 4 5 6 ] will further facilitate the process of rational prescribing. [ 3 6 ] Several studies showed that self-care behavior specific to glucose monitoring plays a vital role in the management of glycemic levels.…”

“…[ 3 6 ] Several studies showed that self-care behavior specific to glucose monitoring plays a vital role in the management of glycemic levels. [ 2 3 4 5 6 ]…”