The impact of diabetes mellitus on health-related quality of life in Saudi Arabia

Quality of Life and Its Determinants Among Individuals With Diabetes in Saudi Arabia: A Cross-Sectional Online Survey

Background Diabetes mellitus is a significant public health issue globally, with increasing prevalence rates. In Saudi Arabia, a substantial proportion of the adult population is affected. While the impact of diabetes on physical health is well-documented, less is known about its effects on emotional and social well-being in this region. Methods From January to March 2024, we conducted a cross-sectional online survey of 207 individuals with diabetes in Saudi Arabia. The survey, available in Arabic and English, assessed physical symptoms, emotional health, social interactions, and overall quality of life. Descriptive statistics were used for analysis. Results The majority of participants were aged 31-45 years (n=63, 30.4%) and female (n=118, 56.9%). Type 2 diabetes was the most common (n=122, 59.1%). Regarding physical health, 34.6% (n=72) rated their health as good while 37.2% (n=77) experienced physical symptoms sometimes and 17.9% (n=37) often. Emotional health challenges were reported by 39.2% (n=81) experiencing anxiety and 33.9% (n=70) experiencing depression. Social interactions were impacted, with 28.6% (n=59) reporting challenges in relationships and 14.3% (n=30) facing significant impacts on recreational activities. Overall quality of life was rated as good by 40.4% (n=83), fair by 29.9% (n=62), and very poor by 4.8% (n=10). Conclusions The study highlights the significant effects of diabetes on the physical, emotional, and social aspects of life in Saudi Arabia. The findings underscore the need for comprehensive care strategies that incorporate medical treatment, emotional support, and social integration to improve the overall quality of life for individuals with diabetes.

The relationship between the duration of diabetes and dimensions of general health and quality of life associated with the health of diabetic patients

Introduction

Diabetes is one of the most common chronic diseases in the world. Diabetes has a major impact on the quality of life of patients. The purpose of this study is the relationship between the duration of diabetes and dimensions of general health and quality of life associated with the health of diabetic patients.

Materials and Methods

In this cross-sectional-analytical study, diabetic patients with more than 1-year history who were not suffering from other chronic diseases were included in the study. Then, using 15 questions for diabetes quality of life, questionnaires and GHQ28 general health were investigated in terms of quality of life and general health. The data were statistically analyzed using SPSS version 24 software.

Results

The average age was equal to 42.8 ± 14.4 years (with a median of 40 years). The average duration of the disease in the patients was equal to 7.7 ± 7.2 years (with a median of 5 years). The average quality of life score of the patients was equal to 50.3 ± 7.8 (out of 75). A negative and significant correlation between age and quality of life of patients was observed (P < 0.001). The duration of the disease had a direct and significant relationship with the general health score. But a significant difference between the quality of life of married and single people was not observed (P = 0.613). A direct and significant relationship between duration of disease, age with physical symptoms (P < 0.001), anxiety and insomnia (P = 0.001), social activity failure (P = 0.013), and depression (P = 0.001) was observed and was also observed with the overall score of general health (P < 0.001).

Discussion and Conclusion

The duration of diabetes disease affects the quality of life and general health of diabetic patients, and discomfort, depression, and anxiety are the main problems that affect the quality of life of diabetic patients.

Assessment of Health-Related Quality of Life Among Patients with Chronic Diseases and Its Relationship with Multimorbidity: A Cross-Sectional Study from Saudi Arabia

Objective

Chronic diseases hold the potential to worsen the overall health of patients by limiting their functional status, productivity, and capacity to live well, affecting their overall health-related quality of life (HRQoL). The purpose of the study was to assess the HRQoL of individuals with chronic diseases residing in the Al-Jouf region of Saudi Arabia. Furthermore, the current study also sought to ascertain the impact of multimorbidity and the duration of illness on HRQoL.

Material and Methods

A cross-sectional study was conducted among the residents of Al-Jouf region for a period of 6 months. A self-administered EuroQoL (EQ-5D-5L) study tool was used. Appropriate statistical analysis was conducted to ascertain the relationship between various variables and HRQoL.

Results

A total of 500 out of 562 participants completed the study, with a response rate of 88.97%. Participants had a mean age of 46.15 ± 16.79 years, and the majority were female (n = 299; 59.80%). A mean HRQoL score of 0.82 ± 0.20 was reported, poorest in patients with kidney failure (0.65 ± 0.26) and highest in hepatitis. However, nearly half of the participants had diabetes mellitus type II (n = 205, 39.20%). Patients aged <30 years (OR: 0.109; p = 0.002), male participants (OR: 0.053; p < 0.001), no disability (OR: 0.143; p = 0.002), and <2 comorbid diseases (0.84 ± 0.18; p < 0.001) reported better QoL. Additionally, comorbid conditions such as DM, prolong the duration of the overall illness (14.19 ± 7.67 years). Overall, imperfect health (n = 390, 78%) was reported by the study participants.

Conclusion

The present study provided preliminary data about the current HRQoL status of individuals with imperfect health and lower HRQoL. In the future, large-scale longitudinal studies are required to investigate the most prevalent chronic diseases, their associations, and change in HRQoL, as there is a dearth of information in the Saudi population.

Prevalence of diabetes mellitus among stroke patients in Ethiopia: Systematic review and meta-analysis

Background

Diabetes mellitus (DM) is a chronic metabolic condition that considerably increases the risk of stroke. According to studies, stroke patients with diabetes have a greater mortality rate and are more likely to have repeated strokes than those without diabetes. Therefore, this systematic review and meta-analysis determined the pooled prevalence of diabetes mellitus among stroke patients in Ethiopia.

Methods

The searches were conducted in electronic databases such as PubMed/MEDLINE, EMBASE, Science Direct, Web of Science, and Google Scholar. Observational study designs were selected, and studies published until November 30, 2023, addressing the prevalence of diabetes mellitus among stroke patients were identified. EndNote Citation Manager software version X9 for Windows was used to collect and organize the search outcomes and remove duplicate articles. Relevant data were extracted from the included studies using a format prepared in Microsoft Excel and exported to STATA 18.0 software for outcome measures analyses and subgrouping.

Results

Twenty-eight research articles were included in the final analysis. The studies included an evaluation of 6589 stroke patients, among whom 645 were diagnosed with DM. This resulted in a pooled prevalence estimate of 10 % (95 % CI: 8-13 %)] DM. The subgroup analysis by region revealed that the highest pooled prevalence of DM was 16 % [95 % CI: (9 %-24 %)], which was from the Oromia region, followed by Addis Ababa city 12 % [95 % CI: (10 %-14 %)]. The other three regions (Tigray, South Nations nationalities and people's region and Amhara) had similar pooled prevalence of DM 7 % [95 % CI: (3 %-10 %)], 7 % [95 % CI: (3 %-11 %)], 7 % [95 % CI: (4 %-9%)], respectively.

Conclusion

Overall, the prevalence of DM among stroke patients is high. Notably, the Oromia region exhibited the highest prevalence rate at 16 %, followed by Addis Ababa city at 12 %. Conversely, the other three regions displayed similar rates of 7 %. These findings underscore the critical importance of screening and managing DM in stroke patients.

Pectin as a biofunctional food: comprehensive overview of its therapeutic effects and antidiabetic-associated mechanisms

Pectin is a complex polysaccharide found in a variety of fruits and vegetables. It has been shown to have potential antidiabetic activity along with other biological activities, including cholesterol-lowering properties, antioxidant activity, anti-inflammatory and immune-modulatory effects, augmented healing of diabetic foot ulcers and other health benefits. There are several pectin-associated antidiabetic mechanisms, such as the regulation of glucose metabolism, reduction of oxidative stress, increased insulin sensitivity, appetite suppression and modulation of the gut microbiome. Studies have shown that pectin supplementation has antidiabetic effects in different animal models and in vitro. In human studies, pectin has been found to have a positive effect on blood glucose control, particularly in individuals with type 2 diabetes. Pectin also shows synergistic effects by enhancing the potency and efficacy of antidiabetic drugs when taken together. In conclusion, pectin has the potential to be an effective antidiabetic agent. However, further research is needed to fully understand its detailed molecular mechanisms in various animal models, functional food formulations and safety profiles for the treatment and management of diabetes and associated complications in humans. The current study was carried out to provide the critical approach towards therapeutical potential, anti-diabetic potential and underlying molecular mechanisms on the basis of existing knowledge.

Assessment and Factors Contributing to the Quality of Life in Diabetes Mellitus Patients: A Cross-Sectional Single-Center Study

Introduction Diabetes mellitus (DM) is one of the most common chronic illnesses worldwide, with its prevalence rising rapidly every year. This condition adversely affects vasculature, leading to several potentially devastating complications like cerebrovascular mishaps, myocardial infarction, retinal damage, and renal compromise. These sequelae could lead to serious disabilities and negatively impact quality of life (QoL). Objectives This study aims to assess the QoL of adult diabetic patients in Saudi Arabia and determine influencing socio-demographic factors. Methods This is a cross-sectional study targeting adult diabetic patients visiting the Imam Medical Center in Riyadh, Saudi Arabia, from October 2022 to June 2023. The study encompasses diabetic patients of both genders aged 18 or more but excludes those diagnosed recently, i.e., within less than one year. A validated Arabic questionnaire, available online, was used to assess the QoL of the diabetic patients enrolled in this study. The sample size was 244 adult diabetic patients recruited from the Imam Medical Center through their official social media sites. Results The cohort of 244 patients recruited in this study were mostly aged between 18 and 30 (44.7%), females (52.5%), and married (47.5%). Furthermore, 58.6% of the participants were found to hold a bachelor's degree, 48.8% were employed, and 36.1% earned less than 5000 Saudi riyals each month. Of the total patients, 36.5% were diagnosed with diabetes 1-5 years ago, while 30.5% were diagnosed 5-10 years ago. Type 1 diabetes afflicted 48.4% of participants, whereas 47.1% were affected by type 2 diabetes. It was also determined that type 2 diabetic patients have higher overall QoL scores than type 1 diabetic patients. QoL had a high mean score of 22.05±4.4. The psychological/spiritual domain has the greatest mean score of 24.06±5.4, while the social and economic domain has the lowest (20.58±4.6). The majority of participants (71.3%) did not have other chronic conditions, whereas hypertension (18%) is the prevalent comorbidity, followed by respiratory ailments (7.4%) and cardiovascular disease (3.3%). Furthermore, people with hypertension had a higher total QoL and four life domain scores than those with cardiovascular and respiratory disorders. Conclusion The relevance of the findings is that it could aid health practitioners in developing techniques to encourage patients to undertake self-care to improve physiological management of the condition and reduce complications.

Health-related quality of life and associated factors in elderly individuals with dyslipidemia in rural Northern China

PURPOSE

The purpose of the study was to investigate health-related quality of life (HRQOL) and its associated factors among elderly individuals with dyslipidemia in rural Northern China.

METHODS

A cross-sectional study was conducted on 457 elderly individuals. The EQ-5D-5L questionnaire was used to assess HRQOL. Sociodemographic, anthropometric, lifestyle and health information was collected using a structured and standardized questionnaire. The Tobit regression model and multiple linear regression analysis were used to assess factors associated with HRQOL parameters including utility index and visual analogue score (EQ-VAS).

RESULTS

The mean age of the participating individuals was 68.04 ± 5.98 years. The median utility index and EQ-VAS scores were 0.942 (P25-P75: 0.876-1.000) and 80 (P25-P75: 70-90), respectively. Pain/discomfort was the most frequently reported complaint among the five health dimensions (50.5%). Illiterate and primary education levels, unemployed, widowed, smoking, secondhand smoke exposure, with hypertension or DM, chronic disease core knowledge scores < 8, and daily sedentary time ≥ 6 h were associated with lower HRQOL.

CONCLUSION

Pain/discomfort dimension was the most affected problems. Education, occupation, marital status, smoking, secondhand smoke exposure, chronic disease core knowledge, comorbidities, and daily sedentary time were significantly associated with HRQOL in the present study.

Insulin injection practice and health related quality of life among individuals with diabetes at Tikur Anbessa Specialized Hospital, Ethiopia: a cross-sectional study

BACKGROUND

Insulin therapy can be inconvenient, painful, burdensome, and restrict patients' daily activities and health related quality of life (HRQOL) due to improper injection techniques or the nature of administration.

OBJECTIVE

This study aimed to assess insulin injection practice, HRQOL and predictors among patients treated with insulin at Tikur Anbessa Specialized Hospital (TASH).

METHODS

An institutional-based cross-sectional study was conducted among diabetes patients on insulin therapy from May to June 2022. A structured questionnaire was used to collect patient characteristics and insulin injection practice. The validated Amharic version of an EQ-5D-5L tool was used to assess the HRQOL. The data was analyzed using SPSS version 26. The patient data were summarized using descriptive statistics. One-way ANOVA using Kruskal-Wallis H tests was used to assess factors that predict insulin handling practice scores. Multivariate linear regression analysis was used to assess factors affecting HRQOL among diabetes patients treated with insulin. The EQ5D-5L utility scores of the patients were calculated using disutility coefficients taken from the Ethiopian general population. Statistical significance was declared at p-value < 0.05.

RESULTS

Of 319 patients who agreed and completed the survey, 51.1% of them were males. Almost half of the participants (n = 158) were > 50 years of age. Among the study participants, 62.1% were only on intermediate acting insulin. A significantly higher proportion of participants 291(91.2%) in this study were taking insulin two times per day. Most of the participants 234(73.4%) had fair practice with a median insulin handling practice score of 38 out of 56. Patient characteristics such as age, educational status, occupation, disease duration, and type of diabetes were significantly association with insulin injection practice (p < 0.05). The mean ± SD utility score of patients were 0.89 ± 0.19 (ranged from -0.04 to 1). Being female (β = -5.42, 95%CI:-8.63,-2.21, p = 0.001) and treated for type-I diabetes mellitus (β =  + 9.04, 95%CI: 4.23,13.85, p-value < 0.0001) were significantly associated with HRQOL of patients on insulin therapy.

CONCLUSION

The study participants had fair practices in insulin handling, storage, and administration techniques, and it was seen that male and type one diabetes patients have a better quality of life compared to their counterparts.

Perceived social supports and associated factors among diabetes mellitus patients

Purpose

The aim of this study was to assess the Perceived Social Supports and Associated Factors Among Diabetes Mellitus Patients.

Methods and materials

A facility-based cross-sectional study on 399 randomly selected adult diabetes patients was conducted at JUMC with data collection between August and September 2021.The data was collected using diabetic social support tool through face-to-face interviews and document review checklist. Logistic regression was used to determine factors associated with perceived social support in diabetes patients.

Result

Two hundred nineteen (54.9%) out of 399 diabetes patients reported a good level of perceived social support. Informational support was the most reported (55.4%), followed by emotional support (52.9%), companionship support (52.9%), and instrumental or tangible support (48.8%). Having a family history of diabetes (AOR = 1.90, CI: 1.09, 3.51) and presence of chronic comorbidities (AOR = 2.01; CI: 1.08, 3.75) were positively associated with social support. Whereas unemployment (AOR = 0.09, CI: 0.02, 0.38) was negatively associated with social support.

Conclusion and recommendations

One of every two diabetes patients got adequate level of social support. Health care system, along with other stakeholders could strengthen social support in line with diabetes patients' lifestyle.

Predictors that affect the Quality of Life Patient with Diabetes Mellitus: A Systematic Review

BACKGROUND: Diabetes mellitus is a disease that has received worldwide attention because its incidence continues to increase so that more research is needed, especially regarding the quality of life of diabetes mellitus patients considering that quality of life is one of the targets of diabetes mellitus management therapy. AIM: The purpose of the literature review is to review the factors that affect the quality of life of diabetes mellitus patients. METHOD: Literature reviews are conducted based on issues, methodologies, equations, and further research proposals. RESULTS: There is an influence of sociodemographic factors and behavioral factors of self-care activities on the quality of life of diabetes mellitus patients. CONCLUSION: Sociodemographic factors and behavioral factors of self-care activities affect the quality of life of patients with diabetes mellitus.

Health-Related Quality of Life of Patients with Type 2 Diabetes Mellitus and Hypertension in Addis Ababa, Ethiopia

Background

The aim of this study was to assess the health-related quality of life of patients with T2DM and hypertension attending public health facilities in Addis Ababa, Ethiopia.

Methods

A cross-sectional study was conducted from 1^st through 30^th August 2020 at the selected institutions. Health facilities were chosen purposively based on patient load. Participants were drawn after proportional to size allocation. A translated EQ-5D-3L, and EQ-VAS instrument was used to collect the data. Analysis was done using SPSS v.26.0. Both parametric and non-parametric models were applied in the analysis.

Results

Of the 409 participants included, the majority were in the age group of 46-60 (36.0%), females (56.0%), from hospitals (54.8%), jobless (25.4%), and married (63.3%). Over two-thirds of the patients reported no problems with self-care, usual activity, and depression/anxiety. All dimensions showed an increasing proportion of moderate to severe problems in the age group beyond 45. Facility type, comorbid condition and age showed a statistically significant score difference for QoL. The overall prevalence of any problem was 59.0%. Education level, visit to a health center, and marriage showed lower odds of affected HRQoL whereas, lower monthly income and presence of comorbidities were opposite.

Conclusion

HRQoL of patients in the study settings was suboptimal and below the general population. Attributes, such as education, facility type, marital status, income level, and comorbid status have a statistically significant association with HRQoL. Arrangement of a safe and quality health services is paramount, especially, during the COVID-19 pandemic.

Quality of Life (QoL) among Health Care Workers with Diabetes Mellitus: A Literature Review

OBJECTIVE

This scoping literature review explores the impact of diabetes mellitus (DM) on the health-related quality of life (HRQoL) of health care workers (HCWs). HCWs play a vital role in the global health care system, with the COVID-19 pandemic demonstrating their effectiveness and worth beyond any doubt. However, HCWs are among the most vulnerable members of the health care system because they are most susceptible to stress, exhaustion, and occupational health risks.

METHOD

The review was conducted in 2021 and included articles published in English in the past five years that explore diabetic HCWs' QoL and studies intended to assess the relationship between work stress and DM. In total, 27 relevant articles were found that satisfied the inclusion criteria and were critically and thematically analyzed.

RESULTS

Most DM studies have focused on the clinical management of patients, but researchers have paid little attention to the high-risk group of HCWs with diabetes. In addition to fulfilling their job mandate, HCWs are burdened with various sociological stressors that affect their QoL.

CONCLUSION

This literature review suggests DM has a significant impact on QoL in the work-life context. However, there is limited evidence to demonstrate the impact of DM on the QoL of HCWs. Thus, further research is needed in this area to improve the provision of integrated care.

Application of the EQ-5D in the Middle East: A Systematic Review Focusing on Patients Living in the Kingdom of Saudi Arabia

Patients’ quality of life (QoL) and reported outcomes are critical indicators of the burden of a disease and the benefits of healthcare intervention. This systematic review explores publications that have adapted the EQ-5D for use with a population living in Saudi Arabia. The review of the following databases: MEDLINE, EMBASE, Wiley’s Database, EBSCO, and ClinicalTrials.gov was conducted on December 1, 2020. The search strategy was adapted from the SPIDER search tool, and the included articles were classified by author, year of publication, region, disease of interest, sample size, type of EQ-5D, and format. Level of EQ-5D was classified as either 3L or 5L. Thirteen articles met the search inclusion criteria. The earliest publication was conducted in 2015 and the latest in 2020. These studies were conducted in four Saudi administrative regions, and multiple conditions or treatments were studied, the most studied condition being diabetes mellitus, followed by musculoskeletal disorders, back pain, and injuries. This systematic review article finds that the EQ-5D has been well adapted in the KSA. However, continued work is needed to investigate the quality of life for major conditions such as cardiovascular disease and cancer. Moreover, QoL research is lacking in certain regions, such as southern and northern Saudi Arabia. Despite the successful application and validation of the EQ-5D, a local QoL tool is needed to capture the unique context of patients within the healthcare system in the Middle East.