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Fidan C, Ağırbaş İ. The health-related quality of life of patients with type 1 and type 2 diabetes mellitus: a meta-analysis. Endocrine 2024; 85:1170-1177. [PMID: 38632164 DOI: 10.1007/s12020-024-03824-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/06/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE We need to know about the health-related quality of life (HRQoL) of patients with diabetes mellitus (DM) to assess their health outcomes. Quantitative studies have discussed whether patients with Type 1 DM (T1DM) have better HRQoL than those with Type 2 DM (T2DM) or vice versa. However, no meta-analyses have addressed the HRQoL of patients with T1DM and T2DM together. Therefore, the primary objective of this meta-analysis was to investigate the HRQoL of patients with T1DM and T2DM. The secondary objective of this meta-analysis was to use various scales to assess the HRQoL of patients with T1DM and T2DM. METHODS The inclusion criteria were (1) study participants were diagnosed with T1DM and T2DM and were aged 18 years or older, (2) outcome measure was HRQoL as assessed by appropriate instruments, (3) study written in the English language, (4) research articles using quantitative research methods, (5) study with full-text access, and (6) study reporting the necessary statistics to calculate the effect size. Cohen's d was used to calculate effect sizes, while the random effect model was used to calculate the joint effect size. RESULTS The sample consisted of seven articles, which recruited a total of 4.896 patients with DM. Patients with T1DM and T2DM had similar HRQoL. According to the EQ-5D-5L, patients with T1DM had a higher HRQoL than those with T2DM. According to the EQ-5D-VAS and SF-36, patients with T1DM and T2DM had similar HRQoL. The Egger's regression analysis indicated no publication bias. CONCLUSION Our results are sample-specific and cannot be generalized to all patients with DM. Therefore, more research is warranted on this topic.
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Affiliation(s)
- Cuma Fidan
- Department of Healthcare Management, Muş Alparslan University, Muş, Turkey.
| | - İsmail Ağırbaş
- Department of Healthcare Management, Ankara University, Ankara, Turkey
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Izadi N, Shafiee A, Niknam M, Yari-Boroujeni R, Azizi F, Amiri P. Socio-behavioral determinants of health-related quality of life among patients with type 2 diabetes: comparison between 2015 and 2018. BMC Endocr Disord 2024; 24:73. [PMID: 38769507 PMCID: PMC11103869 DOI: 10.1186/s12902-024-01604-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Type 2 diabetes (T2D) is a common chronic disease that significantly affects an individual's overall health and well-being. The aim of this study is to investigate the factors that influence the health-related quality of life (HRQoL) of patients with T2D. METHODS This study conducted using data from 6th phase (2015-2017) and 7th phase (2018-2022) of the Tehran Lipid and Glucose Study (TLGS). Data were collected through a combination of interviews, physical examinations, and laboratory tests. Quality of life questionnaire (SF-12) that consists of 12 questions was used to assess physical and mental health functioning. The generalized estimating equation model was used to assess the association between socio-behavioral factors and changes in HRQoL. RESULTS The study included 498 patients with T2D. The changes in HRQoL in patients with T2D followed a sex-specific pattern. Analysis of the physical component score (PCS) and the mental component score (MCS) showed a non-significant change in the total score during the three-year longitudinal study. However, the role physical (RP) of the PCS and the social functioning (SF) of the MCS showed a statistically significant change during this period. In addition, sex, body mass index (BMI), and having cardiovascular disease (CVD) and chronic kidney disease (CKD) showed a significant association with RP changes, and only job status showed a significant association with SF changes. CONCLUSIONS By recognizing the sex-specific patterns in HRQoL changes and understanding the multifaceted nature of factors such as BMI, CVD and CKD, healthcare professionals can develop targeted interventions that go beyond traditional diabetes management.
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Affiliation(s)
- Neda Izadi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arman Shafiee
- School of Medicine, Alborz University of Medical Sciences, Alborz, Iran
| | - Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Yari-Boroujeni
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Werkman NCC, García-Sáez G, Nielen JTH, Tapia-Galisteo J, Somolinos-Simón FJ, Hernando ME, Wang J, Jiu L, Goettsch WG, van der Kallen CJH, Koster A, Schalkwijk CG, de Vries H, de Vries NK, Eussen SJPM, Driessen JHM, Stehouwer CDA. Disease severity-based subgrouping of type 2 diabetes does not parallel differences in quality of life: the Maastricht Study. Diabetologia 2024; 67:690-702. [PMID: 38206363 PMCID: PMC10904551 DOI: 10.1007/s00125-023-06082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/24/2023] [Indexed: 01/12/2024]
Abstract
AIMS/HYPOTHESIS Type 2 diabetes is a highly heterogeneous disease for which new subgroups ('clusters') have been proposed based on disease severity: moderate age-related diabetes (MARD), moderate obesity-related diabetes (MOD), severe insulin-deficient diabetes (SIDD) and severe insulin-resistant diabetes (SIRD). It is unknown how disease severity is reflected in terms of quality of life in these clusters. Therefore, we aimed to investigate the cluster characteristics and cluster-wise evolution of quality of life in the previously defined clusters of type 2 diabetes. METHODS We included individuals with type 2 diabetes from the Maastricht Study, who were allocated to clusters based on a nearest centroid approach. We used logistic regression to evaluate the cluster-wise association with diabetes-related complications. We plotted the evolution of HbA1c levels over time and used Kaplan-Meier curves and Cox regression to evaluate the cluster-wise time to reach adequate glycaemic control. Quality of life based on the Short Form 36 (SF-36) was also plotted over time and adjusted for age and sex using generalised estimating equations. The follow-up time was 7 years. Analyses were performed separately for people with newly diagnosed and already diagnosed type 2 diabetes. RESULTS We included 127 newly diagnosed and 585 already diagnosed individuals. Already diagnosed people in the SIDD cluster were less likely to reach glycaemic control than people in the other clusters, with an HR compared with MARD of 0.31 (95% CI 0.22, 0.43). There were few differences in the mental component score of the SF-36 in both newly and already diagnosed individuals. In both groups, the MARD cluster had a higher physical component score of the SF-36 than the other clusters, and the MOD cluster scored similarly to the SIDD and SIRD clusters. CONCLUSIONS/INTERPRETATION Disease severity suggested by the clusters of type 2 diabetes is not entirely reflected in quality of life. In particular, the MOD cluster does not appear to be moderate in terms of quality of life. Use of the suggested cluster names in practice should be carefully considered, as the non-neutral nomenclature may affect disease perception in individuals with type 2 diabetes and their healthcare providers.
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Affiliation(s)
- Nikki C C Werkman
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Gema García-Sáez
- Bioengineering and Telemedicine Group, Centro de Tecnología Biomédica, ETSI de Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER)-BBN: Networking Research Center for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
| | - Johannes T H Nielen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - Jose Tapia-Galisteo
- Bioengineering and Telemedicine Group, Centro de Tecnología Biomédica, ETSI de Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER)-BBN: Networking Research Center for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
| | - Francisco J Somolinos-Simón
- Bioengineering and Telemedicine Group, Centro de Tecnología Biomédica, ETSI de Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | - Maria E Hernando
- Bioengineering and Telemedicine Group, Centro de Tecnología Biomédica, ETSI de Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER)-BBN: Networking Research Center for Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
| | - Junfeng Wang
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Li Jiu
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Wim G Goettsch
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
- National Health Care Institute, Diemen, the Netherlands
| | - Carla J H van der Kallen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Hein de Vries
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Nanne K de Vries
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Johanna H M Driessen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
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