Lygidakis Charilaos, Uwizihiwe Jean Paul, Bia Michela, Uwinkindi Francois, Kallestrup Per, Vögele Claus
Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda.
BMJ Open. 2021 Feb 19;11(2):e043997. doi: 10.1136/bmjopen-2020-043997.
To report on the disease-related quality of life of patients living with diabetes mellitus in Rwanda and identify its predictors.
Cross-sectional study, part of the baseline assessment of a cluster-randomised controlled trial.
Outpatient clinics for non-communicable diseases of nine hospitals across Rwanda.
Between January and August 2019, 206 patients were recruited as part of the clinical trial. Eligible participants were those aged 21-80 years and with a diagnosis of diabetes mellitus for at least 6 months. Illiterate patients, those with severe hearing or visual impairments, those with severe mental health conditions, terminally ill, and those pregnant or in the postpartum period were excluded PRIMARY AND SECONDARY OUTCOME MEASURES: Disease-specific quality of life was measured with the Kinyarwanda version of the Diabetes-39 (D-39) questionnaire. A glycated haemoglobin (HbA1c) test was performed on all patients. Sociodemographic and clinical data were collected, including medical history, disease-related complications and comorbidities.
The worst affected dimensions of the D-39 were 'anxiety and worry' (mean=51.63, SD=25.51), 'sexual functioning' (mean=44.58, SD=37.02), and 'energy and mobility' (mean=42.71, SD=20.69). Duration of the disease and HbA1c values were not correlated with any of the D-39 dimensions. A moderating effect was identified between use of insulin and achieving a target HbA1c of 7% in the 'diabetes control' scale. The most frequent comorbidity was hypertension (49.0% of participants), which had a greater negative effect on the 'diabetes control' and 'social burden' scales in women. Higher education was a predictor of less impact on the 'social burden' and 'energy and mobility' scales.
Several variables were identified as predictors for the five dimensions of quality of life that were studied, providing opportunities for tailored preventive programmes. Further prospective studies are needed to determine causal relationships.
NCT03376607.
报告卢旺达糖尿病患者的疾病相关生活质量，并确定其预测因素。
横断面研究，为一项整群随机对照试验基线评估的一部分。
卢旺达九家医院的非传染性疾病门诊。
2019年1月至8月期间，招募了206名患者作为临床试验的一部分。符合条件的参与者年龄在21 - 80岁之间，且诊断为糖尿病至少6个月。排除文盲患者、严重听力或视力障碍患者、严重精神健康状况患者、绝症患者以及怀孕或产后患者。主要和次要观察指标：采用基尼亚卢旺达语版糖尿病39项问卷（D - 39）测量疾病特异性生活质量。对所有患者进行糖化血红蛋白（HbA1c）检测。收集社会人口学和临床数据，包括病史、疾病相关并发症和合并症。
D - 39受影响最严重的维度是“焦虑与担忧”（均值 = 51.63，标准差 = 25.51）、“性功能”（均值 = 44.58，标准差 = 37.02）和“精力与活动能力”（均值 = 42.71，标准差 = 20.69）。疾病持续时间和HbA1c值与D - 39的任何维度均无相关性。在“糖尿病控制”量表中，胰岛素使用与达到7%的目标HbA1c之间存在调节作用。最常见的合并症是高血压（49.0%的参与者），对女性的“糖尿病控制”和“社会负担”量表有更大的负面影响。高等教育是对“社会负担”和“精力与活动能力”量表影响较小的预测因素。
确定了几个变量作为所研究的生活质量五个维度的预测因素，为定制预防方案提供了机会。需要进一步的前瞻性研究来确定因果关系。
NCT03376607。
