Quality of life in relation to social and disease factors in patients with type 2 diabetes in Lithuania
Aldona Mikailiūkštienė, Algirdas Juozulynas, Laura Narkauskaitė, Kęstutis Žagminas, Jonas Sąlyga, Rimantas Stukas
Med Sci Monit 2013; 19:165-174
Diabetic patients are more than twice as costly to manage as non-diabetic patients, due mainly to the high costs associated with management of diabetic complications. As in most nations of the world, the number of patients with DM is increasing every year in Lithuania. The aim of this study was to determine relation between quality of the life and disease and social factors of patients with type 2 diabetes in Lithuania.
Material and Methods: Independently prepared questions about the subjects of the survey were: gender; age; weight; education; social and marital status; duration of the disease (in years); treatment method; complications; morbidity with arterial hypertension; change in dietary habits after diagnosis of diabetes (started to eat accordingly to recommendations of the therapist); how often nourishment is taken accordingly to recommendations of the therapist; if beginning to exercise after diagnosis of the diabetes; and if exercising, exercises at least 2–3 times per week. Body mass index was calculated as the relation between body mass in kg and height m square (BMI=kg/m2). The hospital anxiety and depression (HAD) scale was used for the evaluation of depression and anxiety. Quality of life of patients was evaluated with the SF-36 questionnaire. We surveyed 1022 patients with type 2 diabetes (372 men and 650 women). Association between quality of the life and explanatory parameters (disease and social factors) were analyzed using the logistic regression analysis model.
Results: We found that women had lower scores than men in all fields of quality of life (p<0.001). Peroral treatment had a positive impact on the quality of life (QL) fields of the role limitations due to emotional problems (ORa 0.16. 95% CI 0.07–0.34; p<0.001). Treatment with insulin had a positive effect on restriction of activity because of emotional problems (ORa – 0.23. 95% CI 0.11–0.49; p<0.001) and mental health (ORa – 0.38. 95% CI 0.19–0.78; p=0.008), but had a negative impact on bodily pain (ORa – 3.95. 95% CI 1.41–11.09; p=0.009) and physical health (ORa – 4.14. 95% CI 2.03–8.47; p<0.001).
Conclusions: Age and BMI are less important factors that can influence quality of life. Peroral treatment positively acted on the role limitations due to emotional problems, bodily pain, and mental health, but had a strong negative effect on emotional state.
Keywords: Quality of Life, Multivariate Analysis, Lithuania, Diabetes Mellitus, Type 2 - pathology, Adult, Questionnaires, Regression Analysis, Socioeconomic Factors