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Published in: Health and Quality of Life Outcomes 1/2019

Open Access 01-12-2019 | Insulins | Research

Demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus living in northern Thailand: A cross-sectional study

Authors: Saneh Khunkaew, Ritin Fernandez, Jenny Sim

Published in: Health and Quality of Life Outcomes | Issue 1/2019

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Abstract

Background

Type 2 Diabetes Mellitus (T2DM) is a chronic disease which is growing global health problems. However, research on such prediction of health-related quality of life (HRQOL) in Thailand is limited, in particular on the demographic and clinical characteristic in each HRQOL domains. Therefore, the aim of the present study was to determine the demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus (T2DM) in Northern Thailand.

Methods

A cross-sectional study of people with T2DM at a large teaching hospital in Northern Thailand was conducted. The HRQOL was evaluated using the Thai version of Diabetes-39. Descriptive analysis was used to summarize the demographic and HRQOL scores. Multiple regression analysis was used to determine the predictors of overall HRQOL and the predictors of each D-39 dimension.

Results

A total of 502 people with T2DM were recruited. Forty-one were identified as having diabetic foot ulcers. The mean score for perception of overall HRQOL was 61.18 (SD 18.74). Scores in the D-39 questionnaire showed a poor HRQOL among people with T2DM. The predictors of demographic and clinical characteristics of people with T2DM were calculated for overall HRQOL and all six domains.

Conclusion

These results demonstrate that people with T2DM have a poor HRQOL. The presence of diabetic foot ulcers and smoking status were identified as significant predictors of low HRQOL in the domains relating to diabetes control, social burden and energy and mobility presence of obesity, receiving insulin injection or a combination of insulin and oral medication were predictors of poor HRQOL in the domain of other health problems and diabetes complications. These findings allow for a nursing care plan for diabetes management to achieve optimal glycaemic control and improve their HRQOL.
Literature
1.
go back to reference Meetoo D. Diabetes: complications and the economic burden. Br J Healthc Manag. 2014;20(2):60–8.CrossRef Meetoo D. Diabetes: complications and the economic burden. Br J Healthc Manag. 2014;20(2):60–8.CrossRef
4.
go back to reference Reutrakul S, Deerochanawong C. Diabetes in Thailand: status and policy. Curr Diab Rep. 2016;16(3):1–10.CrossRef Reutrakul S, Deerochanawong C. Diabetes in Thailand: status and policy. Curr Diab Rep. 2016;16(3):1–10.CrossRef
5.
go back to reference Aekplakorn W, Stolk RP, Neal B, Suriyawongpaisal P, Chongsuvivatwong V, Cheepudomwit S, et al. The prevalence and management of diabetes in Thai adults: the international collaborative study of cardiovascular disease in Asia. Diabetes Care. 2003;26(10):2758–63.CrossRef Aekplakorn W, Stolk RP, Neal B, Suriyawongpaisal P, Chongsuvivatwong V, Cheepudomwit S, et al. The prevalence and management of diabetes in Thai adults: the international collaborative study of cardiovascular disease in Asia. Diabetes Care. 2003;26(10):2758–63.CrossRef
6.
go back to reference Siersma V, Thorsen H, Holstein PE, Kars M, Apelqvist J, Jude EB, et al. Health-related quality of life predicts major amputation and death, but not healing, in people with diabetes presenting with foot ulcers: the Eurodiale study. Diabetes Care. 2014;37(3):694–700. https://doi.org/10.2337/dc13-1212.CrossRefPubMed Siersma V, Thorsen H, Holstein PE, Kars M, Apelqvist J, Jude EB, et al. Health-related quality of life predicts major amputation and death, but not healing, in people with diabetes presenting with foot ulcers: the Eurodiale study. Diabetes Care. 2014;37(3):694–700. https://​doi.​org/​10.​2337/​dc13-1212.CrossRefPubMed
8.
go back to reference Holland CM. Diabetic peripheral neuropathy: a barrier to quality of life. Commun Nurs Res. 2012;45:405. Holland CM. Diabetic peripheral neuropathy: a barrier to quality of life. Commun Nurs Res. 2012;45:405.
10.
go back to reference Carlos De Meneses L, Blanes L, Francescato Veiga D, Gomes HC, Ferreirai LM. Health-related quality of life and self-esteem in patients with diabetic foot ulcers: results of a cross-sectional comparative study. Ostomy Wound Manage. 2011;57(3):36–43. Carlos De Meneses L, Blanes L, Francescato Veiga D, Gomes HC, Ferreirai LM. Health-related quality of life and self-esteem in patients with diabetic foot ulcers: results of a cross-sectional comparative study. Ostomy Wound Manage. 2011;57(3):36–43.
11.
go back to reference Garcia-Morales E, Lazaro-Martinez JL, Martinez-Hernandez D, Aragon-Sanchez J, Beneit-Montesinos JV, Gonzalez-Jurado MA. Impact of diabetic foot related complications on the health related quality of life (HRQol) of patients--a regional study in Spain. Int J Low Extrem Wounds. 2011;10(1):6–11. https://doi.org/10.1177/1534734611400257.CrossRefPubMed Garcia-Morales E, Lazaro-Martinez JL, Martinez-Hernandez D, Aragon-Sanchez J, Beneit-Montesinos JV, Gonzalez-Jurado MA. Impact of diabetic foot related complications on the health related quality of life (HRQol) of patients--a regional study in Spain. Int J Low Extrem Wounds. 2011;10(1):6–11. https://​doi.​org/​10.​1177/​1534734611400257​.CrossRefPubMed
12.
go back to reference Zoungas S, Woodward M, Li Q, Cooper ME, Hamet P, Harrap S, et al. Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes. Diabetologia. 2014;57(12):2465–74.CrossRef Zoungas S, Woodward M, Li Q, Cooper ME, Hamet P, Harrap S, et al. Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes. Diabetologia. 2014;57(12):2465–74.CrossRef
13.
go back to reference Al Hayek AA, Robert AA, Al Saeed A, Alzaid AA, Al Sabaan FS. Factors associated with health-related quality of life among Saudi patients with type 2 diabetes mellitus: a cross-sectional survey. Diabetes Metab J. 2014;38(3):220–9.CrossRef Al Hayek AA, Robert AA, Al Saeed A, Alzaid AA, Al Sabaan FS. Factors associated with health-related quality of life among Saudi patients with type 2 diabetes mellitus: a cross-sectional survey. Diabetes Metab J. 2014;38(3):220–9.CrossRef
14.
go back to reference Al-Maskari MY, Al-Shookri AO, Al-Adawi SH, Lin KG. Assessment of quality of life in patients with type 2 diabetes mellitus in Oman. Saudi Med J. 2011;32(12):1285–90.PubMed Al-Maskari MY, Al-Shookri AO, Al-Adawi SH, Lin KG. Assessment of quality of life in patients with type 2 diabetes mellitus in Oman. Saudi Med J. 2011;32(12):1285–90.PubMed
17.
go back to reference Mikailiūkštienė A, Juozulynas A, Narkauskaitė L, Žagminas K, Sąlyga J, Stukas R. Quality of life in relation to social and disease factors in patients with type 2 diabetes in Lithuania. Med Sci Monit. 2013;19:165.CrossRef Mikailiūkštienė A, Juozulynas A, Narkauskaitė L, Žagminas K, Sąlyga J, Stukas R. Quality of life in relation to social and disease factors in patients with type 2 diabetes in Lithuania. Med Sci Monit. 2013;19:165.CrossRef
18.
go back to reference Maddigan SL, Feeny DH, Johnson JA. Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey. Qual Life Res. 2005;14(5):1311–20.CrossRef Maddigan SL, Feeny DH, Johnson JA. Health-related quality of life deficits associated with diabetes and comorbidities in a Canadian National Population Health Survey. Qual Life Res. 2005;14(5):1311–20.CrossRef
19.
go back to reference Wong CK, Lo YY, Wong WH, Fung CS. The associations of body mass index with physical and mental aspects of health-related quality of life in Chinese patients with type 2 diabetes mellitus: results from a cross-sectional survey. Health Qual Life Outcomes. 2013;11(1):142.CrossRef Wong CK, Lo YY, Wong WH, Fung CS. The associations of body mass index with physical and mental aspects of health-related quality of life in Chinese patients with type 2 diabetes mellitus: results from a cross-sectional survey. Health Qual Life Outcomes. 2013;11(1):142.CrossRef
20.
go back to reference Snyder RJ, Hanft JR. Diabetic foot ulcers--effects on QOL, costs, and mortality and the role of standard wound care and advanced-care therapies. Ostomy Wound Manage. 2009;55(11):28–38.PubMed Snyder RJ, Hanft JR. Diabetic foot ulcers--effects on QOL, costs, and mortality and the role of standard wound care and advanced-care therapies. Ostomy Wound Manage. 2009;55(11):28–38.PubMed
21.
go back to reference Khunkaew S, Fernandez R, Sim J. Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Quality of Life Research. 2019;28(6):1413-427.CrossRef Khunkaew S, Fernandez R, Sim J. Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Quality of Life Research. 2019;28(6):1413-427.CrossRef
23.
go back to reference Daher AM, AlMashoor SAH, Winn T. Glycaemic control and quality of life among ethnically diverse Malaysian diabetic patients. Qual Life Res. 2015;24(4):951–8.CrossRef Daher AM, AlMashoor SAH, Winn T. Glycaemic control and quality of life among ethnically diverse Malaysian diabetic patients. Qual Life Res. 2015;24(4):951–8.CrossRef
24.
go back to reference Undén A-L, Elofsson S, Andréasson A, Hillered E, Eriksson I, Brismar K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gend Med. 2008;5(2):162–80.CrossRef Undén A-L, Elofsson S, Andréasson A, Hillered E, Eriksson I, Brismar K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gend Med. 2008;5(2):162–80.CrossRef
26.
go back to reference Huang, I. C., Hwang, C.-C., Wu, M.-Y., Lin, W., Leite, W., & Wu, A. W. (2008). Diabetes-specific or generic measures for health-related quality of life? Evidence from psychometric validation of the D-39 and SF-36. Value in Health, 11(3), 450-461, doi:http://dx.doi.org/https://doi.org/10.1111/j.1524-4733.2007.00261.x. Huang, I. C., Hwang, C.-C., Wu, M.-Y., Lin, W., Leite, W., & Wu, A. W. (2008). Diabetes-specific or generic measures for health-related quality of life? Evidence from psychometric validation of the D-39 and SF-36. Value in Health, 11(3), 450-461, doi:http://​dx.​doi.​org/​https://​doi.​org/​10.​1111/​j.​1524-4733.​2007.​00261.​x.
27.
go back to reference Khunkaew S, Fernandez R, Sim J. Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Qual Life Res. 2019;28(6):1413–27.CrossRef Khunkaew S, Fernandez R, Sim J. Health-related quality of life among adults living with diabetic foot ulcers: a meta-analysis. Qual Life Res. 2019;28(6):1413–27.CrossRef
28.
go back to reference Songraksa K, Lerkiatbundit S. Development of a disease specific quality of life instrument: Thai version of the Diabetic-39. Songkla Med Journal. 2009;27(1):35–49. Songraksa K, Lerkiatbundit S. Development of a disease specific quality of life instrument: Thai version of the Diabetic-39. Songkla Med Journal. 2009;27(1):35–49.
29.
go back to reference Bradley C, Eschwège E, de Pablos-Velasco P, Parhofer KG, Simon D, Vandenberghe H, et al. Predictors of quality of life and other patient-reported outcomes in the PANORAMA multinational study of people with type 2 diabetes. Diabetes Care. 2018;41(2):267–76.CrossRef Bradley C, Eschwège E, de Pablos-Velasco P, Parhofer KG, Simon D, Vandenberghe H, et al. Predictors of quality of life and other patient-reported outcomes in the PANORAMA multinational study of people with type 2 diabetes. Diabetes Care. 2018;41(2):267–76.CrossRef
31.
go back to reference Zulian LR, Santos MA d, Veras VS, Rodrigues FFL, Arrelias CCA, Zanetti ML. Quality of life in patients with diabetes using the diabetes 39 (D-39) instrument. Revi Gaucha Enferm. 2013;34(3):138–46.CrossRef Zulian LR, Santos MA d, Veras VS, Rodrigues FFL, Arrelias CCA, Zanetti ML. Quality of life in patients with diabetes using the diabetes 39 (D-39) instrument. Revi Gaucha Enferm. 2013;34(3):138–46.CrossRef
32.
go back to reference López-Carmona JM, Rodríguez-Moctezuma R. Adaptation and validation of quality of life instrument diabetes 39 for Mexican patients with type 2 diabetes mellitus 200. Salud publica Mex. 2006;48(3):200–11.CrossRef López-Carmona JM, Rodríguez-Moctezuma R. Adaptation and validation of quality of life instrument diabetes 39 for Mexican patients with type 2 diabetes mellitus 200. Salud publica Mex. 2006;48(3):200–11.CrossRef
33.
go back to reference Chen G, Iezzi A, McKie J, Khan MA, Richardson J. Diabetes and quality of life: comparing results from utility instruments and Diabetes-39. Diabetes Res Clin Pract. 2015;109(2):326–33.CrossRef Chen G, Iezzi A, McKie J, Khan MA, Richardson J. Diabetes and quality of life: comparing results from utility instruments and Diabetes-39. Diabetes Res Clin Pract. 2015;109(2):326–33.CrossRef
34.
go back to reference Hjelm K, Nyberg P, Apelqvist J. Gender influences beliefs about health and illness in diabetic subjects with severe foot lesions. J Adv Nurs. 2002;40(6):673–84.CrossRef Hjelm K, Nyberg P, Apelqvist J. Gender influences beliefs about health and illness in diabetic subjects with severe foot lesions. J Adv Nurs. 2002;40(6):673–84.CrossRef
35.
go back to reference Goodridge D, Trepman E, Sloan J, Guse L, Strain LA, McIntyre J, et al. Quality of life of adults with unhealed and healed diabetic foot ulcers. Foot Ankle Int. 2006;27(4):274–80.CrossRef Goodridge D, Trepman E, Sloan J, Guse L, Strain LA, McIntyre J, et al. Quality of life of adults with unhealed and healed diabetic foot ulcers. Foot Ankle Int. 2006;27(4):274–80.CrossRef
37.
go back to reference Kasteleyn M, De Vries L, Van Puffelen A, Schellevis F, Rijken M, Vos R, et al. Diabetes-related distress over the course of illness: results from the Diacourse study. Diabet Med. 2015;32(12):1617–24.CrossRef Kasteleyn M, De Vries L, Van Puffelen A, Schellevis F, Rijken M, Vos R, et al. Diabetes-related distress over the course of illness: results from the Diacourse study. Diabet Med. 2015;32(12):1617–24.CrossRef
38.
go back to reference Hassali MA, Ching M-W, Yusoff ZM, Hussein Z, Alrasheedy AA, Al-Tamimi SK, et al. ‘Why I do not want to take insulin shots’: findings from a qualitative study among diabetic patients in Malaysia. J Public Health. 2014;22(1):3–11.CrossRef Hassali MA, Ching M-W, Yusoff ZM, Hussein Z, Alrasheedy AA, Al-Tamimi SK, et al. ‘Why I do not want to take insulin shots’: findings from a qualitative study among diabetic patients in Malaysia. J Public Health. 2014;22(1):3–11.CrossRef
39.
go back to reference Boyer JG, Earp JAL. The development of an instrument for assessing the quality of life of people with diabetes: Diabetes-39. Med Care. 1997;35(5):440–53.CrossRef Boyer JG, Earp JAL. The development of an instrument for assessing the quality of life of people with diabetes: Diabetes-39. Med Care. 1997;35(5):440–53.CrossRef
Metadata
Title
Demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus living in northern Thailand: A cross-sectional study
Authors
Saneh Khunkaew
Ritin Fernandez
Jenny Sim
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2019
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-019-1246-2

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