Quality of life is an important health outcome in its own right, representing the ultimate goal of all health interventions. This paper reviews the published, English-language literature on self-perceived quality of life among adults with diabetes. Quality of life is measured as physical and social functioning, and perceived physical and mental well-being. People with diabetes have a worse quality of life than people with no chronic illness, but a better quality of life than people with most other serious chronic diseases. Duration and type of diabetes are not consistently associated with quality of life. Intensive treatment does not impair quality of life, and having better glycemic control is associated with better quality of life. Complications of diabetes are the most important disease-specific determinant of quality of life. Numerous demographic and psychosocial factors influence quality of life and should be controlled when comparing subgroups. Studies of clinical and educational interventions suggest that improving patients' health status and perceived ability to control their disease results in improved quality of life. Methodologically, it is important to use multidimensional assessments of quality of life, and to include both generic and disease-specific measures. Quality of life measures should be used to guide and evaluate treatment interventions.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/%28SICI%291520-7560%28199905/06%2915%3A3%3C205%3A%3AAID-DMRR29%3E3.0.CO%3B2-O

Quality of life and diabetes

Background Quality of life (QoL) is commonly assessed in inflammatory bowel disease (IBD); the relationship of QoL within IBD states and relative to others has not been comprehensively evaluated. This systematic review, published across 2 papers, evaluates 5 key QoL comparisons. Part I, presented here, examines between-disease comparisons: (1) IBD/healthy(general) population and (2) IBD/other medically ill groups. Part II examines within-disease comparisons: (3) active/inactive disease, (4) ulcerative colitis/Crohn's disease, and (5) change over time. Outcomes using generic vs IBD-specific QoL measures were also examined. Methods Adult and pediatric studies were identified through systematic searches of 7 databases from the 1940s (where available) to October 2015. Results Of 6173 abstracts identified, 466 were selected for final review based on controlled design and validated measurement; 30 unique studies (23 adult, 7 pediatric) addressed the between-disease comparisons. The pooled mean QoL scores were (1) lower in adult and pediatric IBD samples compared with healthy controls (n = 19), and for both mental and physical QoL, where measured; and (2) higher but not significant for those with IBD compared with various medically ill controls (n = 15). Findings were consistent across IBD-specific and generic QoL measures. Study quality was generally low to moderate. The most common measures of QoL were the disease-specific Inflammatory Bowel Disease Questionnaire and generic SF-36 (adults), and the generic PedsQL (children). Conclusions There was robust confirmation that QoL for individuals with IBD was poorer than for healthy individuals, for both adults and children. QoL in IBD may be better relative to some other gastrointestinal (GI) and non-GI medical conditions for children.

Quality of Life in Inflammatory Bowel Disease: A Systematic Review and Meta-analyses—Part II

Diabetes Mellitus (DM) is a major cause of morbidity and mortality affecting millions of people worldwide, while placing a noteworthy strain on public health funding. The aim of this study was to assess health-related quality of life (HRQOL) of Greek Type II DM patients and to identify significant predictors of the disease in this patient population. The sample (N = 229, 52.8% female, 70.0 years mean age) lived in a rural community of Lesvos, an island in the northeast of the Aegean Archipelagos. The generic SF-36 instrument, administered by trainee physicians, was used to measure HRQOL. Scale scores were compared with non-parametric Mann-Whitney and Kruskal-Wallis tests and multivariate stepwise linear regression analyses were used to investigate the effect of sociodemographic and diabetes-related variables on HRQOL. The most important predictors of impaired HRQOL were female gender, diabetic complications, non-diabetic comorbidity and years with diabetes. Older age, lower education, being unmarried, obesity, hypertension and hyperlipidaemia were also associated with impaired HRQOL in at least one SF-36 subscale. Multivariate regression analyses produced models explaining significant portions of the variance in SF-36 subscales, especially physical functioning (R2 = 42%), and also showed that diabetes-related indicators were more important disease predictors, compared to sociodemographic variables. The findings could have implications for health promotion in rural medical practice in Greece. In order to preserve a good HRQOL, it is obviously important to prevent diabetes complications and properly manage concomitant chronic diseases. Furthermore, the gender difference is interesting and requires further elucidation. Modifying screening methods and medical interventions or formulating educational programs for the local population appear to be steps in the correct direction.

https://link.springer.com/content/pdf/10.1186%2F1471-2458-7-186.pdf

Predictors of health-related quality of life in type II diabetic patients in Greece.

Clinical and psychosocial factors associated with achievement of treatment goals in adolescents with diabetes mellitus.

Purpose: To compare Quality of Life (QoL) between diabetic patients with (former or present) and without foot ulcers. Methods: Two patient groups of comparable age, sex distribution, type distribution and duration of diabetes were studied. Fourteen patients with former or present, but clinically stable diabetic foot ulcers (DFUs) were studied. The control group was 24 unknown patients with DFUs. None of the participants had other diabetic complications or conditions that would potentially affect QoL. A diabetic foot risk score and QoL were assessed. QoL was scored with the RAND-36, the Barthel Score (ADL) and the Walking and Walking Stairs Questionnaire (WSQ). Results: Marked and significant differences were found in physical functioning (p < 0.001), social functioning (p < 0.05), physical role (p < 0.001) and health experience (p < 0.05) between the two groups with the RAND-36 and the four sub scales of the WSQ (all p 0.001). On all these scales, QoL was significantly poorer in the study group. A correla...

Quality of life in patients with diabetic foot ulcers.

OBJECTIVE: The concept of quality of life (QOL) is understood as a multidimensional construct made up of physiological, psychological, and social aspects, but their particular weightings for the global QOL are rarely investigated. We examined 1) the general QOL of patients with diabetes, 2) the significance of the individual QOL aspects for the overall assessment of QOL, and 3) the modulating function of coping mechanism and particular personality traits. RESEARCH DESIGN AND METHODS: A total of 116 diabetes patients under intensified insulin therapy were studied, as were 107 patients with inflammatory bowel disease, 66 patients with chronic hepatitis C, and 229 students who served as control subjects. The examination was based on eight standardized QOL and personality questionnaires (354 items) and assessed by means of linear structural regression models (AMOS 3.6). RESULTS: The QOL of diabetes patients appears to be higher than the QOL of other chronically ill patients. Social, psychological, and physical aspects contribute to the overall QOL, although physical complaints receive a comparatively low weighting. Coping behavior and particular personality traits covary with all QOL aspects, giving these variables greater significance for the QOL than the existence of secondary illnesses. CONCLUSIONS: The hypothesis that the various factors involved in the multidimensional construct QOL receive different weightings was confirmed, making a simple summary score for the general QOL appear unjustifiable. In addition, all aspects that are commonly understood as parameters of QOL are influenced by external factors, such as coping behavior, based on individual personality characteristics.

Determinants of the quality of life of patients with diabetes under intensified insulin therapy.

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Determinants of the quality of life of patients with diabetes under intensified insulin therapy.