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血糖之外:社会经济因素和糖尿病困扰与2型糖尿病患者的健康相关生活质量相关。

Beyond Glycaemia: Socioeconomic Factors and Diabetes Distress are Associated with Health-Related Quality of Life in People with Type 2 Diabetes.

作者信息

Chandran Suresh Rama, Keat Gilbert Soh Keng, Salim Nur Nasyitah Binte Mohamed, Xin Xiaohui, Lim Gek Hsiang, Gardner Daphne, Goh Su-Yen

机构信息

Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.

SingHealth Duke NUS Diabetes Centre, Singapore General Hospital, Singapore, Singapore.

出版信息

J ASEAN Fed Endocr Soc. 2025 May;40(1):72-79. doi: 10.15605/jafes.040.01.19. Epub 2025 Apr 22.

Abstract

BACKGROUND

Diabetes is a complex multifactorial disease. Therapy focused only on managing glycaemia does not yield optimal health outcomes. Health-related Quality of Life (HRQOL) is a broad, subjective, and multidimensional concept gaining significance in diabetes care. The complex interplay of HRQOL and other factors must be addressed to achieve optimal health outcomes.

OBJECTIVE

We aim to describe the factors associated with HRQOL in type 2 diabetes.

METHODOLOGY

A single-center cross-sectional short messaging service (SMS) survey invited adults with type 2 diabetes (T2D) with ≥1 clinic attendance in the past year. Participants completed the Problem Areas in Diabetes-5 (PAID-5), Diabetes Distress Scale-17 (DDS17), and European Quality of Life Score (EQ-5D-5L). Demographic and diabetes-related data were retrieved from electronic medical records. Multiple regression models were created with EQ-5D-5L Index score (HRQOL) as the dependent variable.

RESULT

A total of 1406 people with T2D participated, 46.4% women, mean (SD) age 61.1 (13.4) years, BMI 27.1 (5.4) kg/ m, and HbA1c 8.0 (1.4)%. Of these, 60.9% had ≥1 microvascular and 23.8% had ≥1 macrovascular complication. Mean (SD) of EQ-5D-5L Index score was 0.81 (0.27), EQ5D Visual Analog Score (VAS) was 77.4 (23.8), total mean DDS17 score was 1.87 (0.93) and PAID-5 score was 5.04 (4.5). 26.9% and 11.3% had significant diabetes distress (DD) based on PAID-5 ≥8 and DDS17 ≥3. Multiple regression models revealed diabetes distress, a lower class of housing type, presence of macrovascular complication, higher BMI, older age, and female sex to be associated with a poorer EQ-5D-5L Index Score.

CONCLUSION

Multiple non-glycemic factors like sociodemographic, socioeconomic, diabetes distress, impact health-related QoL in people with type 2 diabetes.

摘要

背景

糖尿病是一种复杂的多因素疾病。仅专注于控制血糖水平的治疗并不能带来最佳的健康结果。健康相关生活质量(HRQOL)是一个广泛、主观且多维度的概念,在糖尿病护理中日益重要。必须解决HRQOL与其他因素之间复杂的相互作用,以实现最佳的健康结果。

目的

我们旨在描述2型糖尿病患者中与HRQOL相关的因素。

方法

一项单中心横断面短信服务(SMS)调查邀请了过去一年中至少就诊过一次的2型糖尿病(T2D)成年患者。参与者完成了糖尿病问题领域-5(PAID-5)、糖尿病困扰量表-17(DDS17)和欧洲生活质量评分(EQ-5D-5L)。人口统计学和糖尿病相关数据从电子病历中获取。以EQ-5D-5L指数评分(HRQOL)作为因变量建立多元回归模型。

结果

共有1406名T2D患者参与,其中46.4%为女性,平均(标准差)年龄61.1(13.4)岁,体重指数27.1(5.4)kg/m²,糖化血红蛋白8.0(1.4)%。其中,60.9%有≥1种微血管并发症,23.8%有≥1种大血管并发症。EQ-5D-5L指数评分的平均(标准差)为0.81(0.27),EQ5D视觉模拟评分(VAS)为77.4(23.8),DDS17总平均评分为1.87(0.93),PAID-5评分为5.04(4.5)。根据PAID-5≥8和DDS17≥3,分别有26.9%和11.3%的患者存在显著的糖尿病困扰(DD)。多元回归模型显示,糖尿病困扰、较低的住房类型、大血管并发症的存在、较高的体重指数、较高的年龄和女性性别与较差的EQ-5D-5L指数评分相关。

结论

社会人口学、社会经济、糖尿病困扰等多种非血糖因素会影响2型糖尿病患者的健康相关生活质量。

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