Quality of Life among Saudi Diabetics

Fahad S. Al-Shehri

Joint Program of Family Medicine, Abha, KSA.

DOI: 10.4236/jdm.2014.43032                

Abstract

Aim of study: To assess QOL among Saudi diabetics and to identify the possible risk factors associated with lower QOL. Patients and Methods: This study comprised 400 diabetic patients attending the Diabetes Clinic at theUniversityDiabetesCenterinRiyadh. They were interviewed using the Audit of Diabetes Dependent QOL (ADDQOL). Results: Most diabetic patients (78.7%) had negative (i.e., unfavorable) ADDQOL scores. Diabetic patients' age, education and occupation were not significantly associated with their QOL. Female patients had significantly worse QOL than male patients (p = 0.026). Married patients had significantly worse QOL compared with non-married patients (p = 0.012). Patients with type 2 diabetes had significantly worse QOL than those with type 1 diabetes (p = 0.029). Duration of diabetes was not significant factors as regard their QOL, with the worst QOL among those with more than 20 years of diabetes. The degree of diabetes control was significantly and directly associated with QOL score (p < 0.001). The worst QOL was expressed among poorly controlled diabetes while the best was among patients with excellent control. QOL of diabetics was less among those who had diabetes complications, i.e., neuropathy (p = 0.03), retinopathy (p < 0.001), and diabetic foot (p = 0.031). However, difference was not significant according to those with nephropathy. Conclusions: QOL of Saudi adult diabetic patients is not favorable. Personal characteristics associated with worse QOL among diabetics include female gender, and being married. Disease characteristics associated with worse QOL include being a type 2 diabetic and those with uncontrolled diabetes. Main complications associated with worse QOL among diabetics include retinopathy, diabetic foot and neuropathy.

Keywords

Quality of Life, Diabetes Mellitus, Retinopathy, Nephropathy, Neuropathy, Diabetic Foot

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Haas, B.K. (1999) A Multidisciplinary Concept Analysis of Quality of Life. Western Journal of Nursing Research, 21, 728. http://dx.doi.org/10.1177/01939459922044153
[2]	Wee, H., Cheung, Y., Li, S., Fong, K. and Thumboo, J. (2005) The Impact of Diabetes Mellitus and Other Chronic Medical Conditions on Health-Related Quality of Life: Is the Whole Greater than the Sum of Its Parts? Health and Quality of Life Outcomes, 3, 2. http://dx.doi.org/10.1186/1477-7525-3-2
[3]	Abdel-Gawad, E.S. (2002) Quality of Life in Saudis with Diabetes. Saudi Journal of Disability and Rehabilitation, 8, 163-168
[4]	Al-Nozha, M.M., Al-Maatouq, M.A., Al-Mazrou, Y.Y., Al-Harthi, S.S., Arafah, M.R., Khalil, M.Z., Khan, N.B., Al-Khadra, A., Al-Marzouki, K., Nouh, M.S., Abdullah, M., Attas, M., Al-Shahid, M.S. and Al-Mobeireek, A. (2004) Diabetes Mellitus in Saudi Arabia. Saudi Medical Journal, 25, 1603-1610.
[5]	Reddy, S.S. () Health Outcomes in Type 2 Diabetes. International Journal of Clinical Practice, Supplement, 113, 46-53.
[6]	Stewart, A.L., Greenfield, S., Hays, R.D., Wells, K., Rogers, W.H., Berry, S.D., McGlynn, E.A. and Ware, Jr., J.E. (1989) Functional Status and Well-Being of Patients with Chronic Conditions. Results from the Medical Outcomes Study. JAMA, 262, 907-913. http://dx.doi.org/10.1001/jama.1989.03430070055030
[7]	Alonso, J., Ferrer, M., Gandek, B., Ware, Jr., J.E., Aaronson, N.K., Mosconi, P., Rasmussen, N.K., Bullinger, M., Fukuhara, S., Kaasa, S., Leplege, A., IQOLA Project Group (2004) Health-Related Quality of Life Associated with Chronic Conditions in Eight Countries: Results from the International Quality of Life Assessment (IQOLA) Project. Quality of Life Research, 13, 283-298. http://dx.doi.org/10.1023/B:QURE.0000018472.46236.05
[8]	Sprangers, M.A., de Regt, E.B., Andries, F., van Agt, H.M., Bijl, R.V., de Boer, J.B., Foets, M., Hoeymans, N., Jacobs, A.E., Kempen, G.I., Miedema, H.S., Tijhuis, M.A. and de Haes, H.C. (2000) Which Chronic Conditions Are Associated with Better or Poorer Quality of Life? Journal of Clinical Epidemiology, 53, 895-907. http://dx.doi.org/10.1016/S0895-4356(00)00204-3
[9]	Rubin, R.R. and Peyrot, M. (2004) Quality of Life and Diabetes. Diabetes/Metabolism Research and Reviews, 15, 205-218. http://dx.doi.org/10.1002/(SICI)1520-7560(199905/06)15:3<205::AID-DMRR29>3.0.CO;2-O
[10]	Vileikyte, L., Leventhal, H., Gonzalez, J.S., Peyrot, M., Rubin, R.R., Ulbrecht, J.S., Garrow, A., Waterman, C., Cavanagh, P.R. and Boulton, A.J (2005) Diabetic Peripheral Neuropathy and Depressive Symptoms: The Association Revisited. Diabetes Care, 28, 2378-2383. http://dx.doi.org/10.2337/diacare.28.10.2378
[11]	Goodridge, D., Trepman, E. and Embil, J.M. (2005) Health-Related Quality of Life in Diabetic Patients with Foot Ulcers: Literature Review. Journal of Wound, Ostomy & Continence Nursing, 32, 368-377. http://dx.doi.org/10.1097/00152192-200511000-00007
[12]	Garratt, A.M., Schmidt, L. and Fitzpatrick, R. (2002) Patient-Assessed Health Outcome Measures for Diabetes: A Structured Review. Diabetic Medicine, 19, 1-11. http://dx.doi.org/10.1046/j.1464-5491.2002.00650.x
[13]	Ghanbari, A., Yekta, Z.P., Roushan, Z.A. and Lakeh, N.M. (2005) Assessment of Factors Affecting Quality of Life in Diabetic Patients in Iran. Public Health Nursing, 22, 311-322. http://dx.doi.org/10.1111/j.0737-1209.2005.220406.x
[14]	Savli, H. and Sevinc, A. (2005) The Evaluation of the Turkish Version of the Well-Being Questionnaire (WBQ-22) in Patients with Type 2 Diabetes: The Effects of Diabetic Complications. Journal of Endocrinological Investigation, 28, 683-691. http://dx.doi.org/10.1007/BF03347550
[15]	Bradley, C., Todd, C., Gorton, T., Symonds, E., Martin, A. and Plowright, R. (1999) The Development of an Individiualised Questionnaire Measure of Perceived Impact of Diabetes on Quality of Life: The ADDQOL. Quality of Life Researcher, 8, 79-91. http://dx.doi.org/10.1023/A:1026485130100
[16]	Al-Shammari, S.A., Nass, M., Al-Maatouq, M.A. and Al-Quaiz, J.M. (1996) Family Practice in Saudi Arabia: Chronic Mortality and Quality of Care. International Journal Quality in Health Care, 8, 383-387. http://dx.doi.org/10.1093/intqhc/8.4.383
[17]	Harris, M.I. (2000) Health Care and Health Status and Outcomes for Patients with Type 2 Diabetes. Diabetes Care, 23, 754-758. http://dx.doi.org/10.2337/diacare.23.6.754
[18]	Aghamollaei, T., Eftekhar, H., Shojaeizadeh, D., Mohammad, K., Nakhjavani, M. and Ghofrani, P.F. (2003) Behavior, Metabolic Control and Health-Related Quality of Life in Diabetic Patients at Bandar Abbas Diabetic Clinic. Iranian Journal of Public Health, 32, 54-59.
[19]	Redekop, W.K., Koopmanschap, M.A., Stolk, R.P., Rutten, G.E., Wolffenbuttel, B.H. and Niessen, L.W. (2002) Health-Related Quality of Life and Treatment Satisfaction in Dutch Patients with Type 2 Diabetes. Diabetes Care, 25, 458-463. http://dx.doi.org/10.2337/diacare.25.3.458
[20]	Laine, C. and Caro, J.F. (1996) Preventing Complications in Diabetes Mellitus. The Role of Primary Care Physician. Medical Clinics of North America, 80, 457-473. http://dx.doi.org/10.1016/S0025-7125(05)70448-X
[21]	Brown, G.C., Brown, M.M., Sharma, S., Brown, H., Gozum, M. and Denton, P. (2000) Quality of Life Associated with Diabetes Mellitus in an Adult Population. Journal of Diabetes and Its Complications, 14, 18-24. http://dx.doi.org/10.1016/S1056-8727(00)00061-1
[22]	de Grauw, W.J., van de Lisdonk, E.H., van Gerwen, W.H., van den Hoogen, H.J. and van Weel, C. (2001) Insulin Therapy in Poorly Controlled Type 2 Diabetic Patients: Does It Affect Quality of Life? British Journal of General Practice, 51, 527-532.
[23]	Walling, A.D. (2002) Type 2 Diabetes Quality of Life and Early Insulin Therapy. American Family Physician, 65, 4.
[24]	Abolfotouh, M.A. (1999) Effect of Diabetes Mellitus on Quality of Life: A Review. Special Communication. Annals of Saudi Medicine, 19, 518-524.
[25]	Woodcock, A., Bradley, C., Plowright, R., Ffytche, T., Kennedy-Martin, T. and Hirsch, A. (2004) The Influence of Diabetic Retinopathy on Quality of Life. Interviews to Guide the Design of a Condition-Specific, Individualised Questionnaire: The RetDQoL. Patient Education and Counseling, 53, 365-383. http://dx.doi.org/10.1016/j.pec.2003.10.007
[26]	Al-Khader, A.A. (2001) Impact of Diabetes in Renal Diseases in Saudi Arabia. Nephrology Dialysis Transplantation, 16, 2132-2135. http://dx.doi.org/10.1093/ndt/16.11.2132
[27]	Al-Zaid, A., Sobki, S. and De Silva, V. (1994) Prevalence of Microalbuminuria in Saudi Arabians with Non-Insulin-Dependent Diabetes Mellitus: A Clinic Based Study. Diabetes Research and Clinical Practice, 26, 115-120. http://dx.doi.org/10.1016/0168-8227(94)90148-1
[28]	Lloyd, A., Sawyer, W. and Hopkinson, P. (2001) Impact of Long-Term Complications on Quality of Life in Patients with Type 2 Diabetes Not Using Insulin. Value in Health, 4, 392-400. http://dx.doi.org/10.1046/j.1524-4733.2001.45029.x
[29]	Tennvalla, G.R. and Apelqvistb, J. (2000) Health-Related Quality of Life in Patients with Diabetes Mellitus and Foot Ulcers. Journal of Diabetes and Its Complications, 14, 235-241. http://dx.doi.org/10.1016/S1056-8727(00)00133-1
[30]	Benbow, S.J., Wallymahmed, M.E. and MacFarlane, I.A. (1998) Diabetic Peripheral Neuropathy and Quality of Life. QJM, 91, 733-737. http://dx.doi.org/10.1093/qjmed/91.11.733