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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (3): 523-529. doi: 10.19723/j.issn.1671-167X.2021.03.014

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Factors associated with quality of life in 747 patients with type 2 diabetes in Tongzhou District and Shunyi District of Beijing

FAN Li-shi1,GAO Min1,Edwin B. FISHER2,SUN Xin-ying1,Δ()   

  1. 1. Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
    2. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, North Carolina 27599-7440, USA
  • Received:2021-03-01 Online:2021-06-18 Published:2021-06-16
  • Contact: Xin-ying SUN E-mail:xysun@bjmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(71673009)

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Abstract:

Objective: To investigate the situation of quality of life in patients with type 2 diabetes and its associated factors. Methods: Questionnaires, physical examination and glycated hemoglobin test were conducted in 747 patients with type 2 diabetes. Hemoglobin A1c (HbA1c) was a proxy for glycemic control, diabetes specific quality of life scale (DSQL) score was a proxy for quality of life. Factors associa-ted with DSQL were analyzed by multiple linear regression and structural equation modeling (SEM). Results: A total of 747 patients were included in this study. The mean HbA1c level was (7.1±1.2)%, with 35.1% reaching the target (262/747). There were significant differences in disease duration, me-dication and use of insulin, smoking, and body mass index (BMI) between the two groups with good and poor glycemic control (P<0.05). The total score of DSQL was 44.92±13.32, in which average phy-siological factors were the highest, then followed by scores of psychological factors. Multiple linear regression showed that monthly household income, comorbidities, depression, duration of illness, insulin, hospitalization, and self-efficacy were significantly associated with the total score of DSQL (P<0.05). SEM showed that blood glucose control was significantly associated with the scores of physical factors (0.166), psychological factors (0.076), and social factors (0.124) of DSQL, respectively. Depression had effects on the physical factors (0.342), psychological factors (0.217), and treatment factors (0.050) of DSQL (P<0.05). Conclusion: Glycemic control in our study is relatively poor but the quality of life remains well. More attention should be paid to patients who are male, with long diagnosis duration, poor medication adherence, smoking, with depression and with low diabetes-related skills. In practice, health practitioners should be aware of psychological needs of patients, and offer mental health education to patients and their families, in order to help patients manage blood glucose and improve their quality of life.

Key words: Diabetes mellitus,type 2, Quality of life, Hemoglobin A,glycosylated, Depression

CLC Number: 

  • R587.1

Table 1

Basic information and glycemic control of type 2 diabetes mellitus patients"

Items n (%) or $\bar{x} \pm s$ Glycemic control, n (%) χ2 P value
Good Bad
Gender 1.182 0.277
Male 359 (48.1) 133 (50.8) 226 (46.6)
Female 388 (51.9) 129 (49.2) 259 (53.4)
Age/years 59.7±7.6 2.056 0.358
≤50 81 (10.8) 23 (8.8) 58 (12.0)
51-60 268 (35.9) 93 (35.5) 175 (36.1)
≥61 398 (53.3) 146 (55.7) 252 (52.0)
Education level 2.858 0.414
Primary school 81 (10.8) 25 (9.5) 56 (11.5)
Middle school 533 (71.4) 184 (70.2) 349 (72.0)
University/College 125 (16.7) 51 (19.5) 74 (15.3)
Graduate school 8 (1.1) 2 (0.8) 6 (1.2)
Marital status 3.459 0.326
Unmarried 3 (0.4) 2 (0.8) 1 (0.2)
Married 703 (94.1) 243 (92.7) 460 (94.8)
Divorced 11 (1.5) 3 (1.1) 8 (1.6)
Widowed 30 (4.0) 14 (5.3) 16 (3.3)
Personal monthly income/Yuan 1.569 0.666
0-3 000 217 (29.0) 72 (27.5) 145 (29.9)
3 001-5 000 331 (44.3) 124 (46.9) 208 (42.9)
5 001-10 000 155 (20.7) 54 (20.6) 101 (20.8)
≥10 000 44 (5.9) 12 (5.0) 31 (6.4)
Course of disease/years 5.0±4.6 19.070 <0.001
0-5 414 (55.4) 172 (65.6) 242 (49.9)
6-10 278 (37.2) 79 (30.2) 199 (41.0)
11-15 39 (5.2) 9 (3.4) 30 (6.2)
≥16 16 (2.1) 2 (0.8) 14 (2.9)
HbA1c/% 7.1±1.2
Complication 0.047 0.828
Yes 607 (81.3) 215 (81.7) 392 (80.8)
No 140 (18.7) 48 (18.3) 92 (19.2)
Smoke 6.953 0.031
Now 180 (24.1) 51 (19.5) 129 (26.6)
Used 116 (15.5) 50 (19.1) 66 (13.8)
Never 451 (60.4) 161 (61.5) 290 (59.8)
BMI 9.633 0.022
Thin 3 (0.4) 3 (1.1) 0 (0)
Normal 168 (22.5) 69 (26.3) 99 (20.4)
Overweight 263 (35.2) 90 (34.4) 173 (35.7)
Obesity 313 (41.9) 100 (38.2) 213 (43.9)
Medication 11.036 <0.001
Yes 649 (86.9) 213 (81.3) 436 (89.9)
No 98 (13.1) 49 (18.7) 49 (10.1)
Insulin 15.074 <0.001
Yes 97 (13.0) 17 (6.5) 80 (16.5)
No 650 (87.0) 245 (93.5) 405 (83.5)
Depressed 0.010 0.919
Yes 124 (16.6) 43 (16.4) 81 (16.7)
No 623 (83.4) 219 (83.6) 404 (16.7)

Table 2

The quality of life scores of type 2 diabetes mellitus patients"

Items Entries, n Quality of life scores Entries evenly split, $\bar{x} \pm s$
Range $\bar{x} \pm s$
DSQL-total 27 33-98 44.92±13.32 1.66±0.49
DSQL-physiology 12 13-48 21.38±7.52 1.78±0.63
DSQL-psychology 8 12-32 13.19±5.01 1.65±0.63
DSQL-sociology 4 4-10 5.83±2.13 1.46±0.53
DSQL-cure 3 4-8 4.52±2.02 1.51±0.67

Table 3

Correlation analysis between 14 factors and total score of DSQL"

Items Correlation coefficient Items Correlation coefficient
Gender 0.082* Smoke 0.065*
Marriage 0.091* Alcohol 0.089*
Hospitalization 0.159# HbA1c 0.072*
Complication 0.124# Course of disease 0.148*
Depression 0.443# BMI 0.026*
Medication -0.066* Self-efficacy -0.146#
Insulin -0.083* Skill -0.063*

Table 4

Multiple linear regression analysis of factors influencing DSQL in type 2 diabetes mellitus patients"

Items B S.E. β t P B (95%CI)
Constant term 24.954 3.888 - 6.418 <0.001 17.320 to 32.587
Income -0.874 0.510 -0.056 -1.716 0.045 -0.159 to -0.039
Complication 3.706 1.118 0.109 3.316 <0.001 1.512 to 5.900
Depressed 15.284 1.176 0.427 12.997 <0.001 12.975 to 17.592
Course of disease 1.389 0.640 0.072 2.168 0.030 0.131 to 2.646
Insulin -2.637 1.315 -0.067 -2.006 0.045 -5.219 to -0.056
Hospitalization 5.690 1.593 0.115 3.572 <0.001 1.683 to 2.229
Self-efficacy 0.401 0.122 0.106 3.278 <0.001 0.161 to 0.641

Figure 1

Structural equation modeling of factors influencing DSQL in type 2 diabetes mellitus patients I101-I127, 27 entries of diabetes specific quality of life scale; K1-K8, 8 entries of patient health questionnaire-8 (PHQ-8). DSQL, diabetes specific quality of life scale; DSQL-Phy, DSQL-physiology; DSQL-Psy, DSQL-psychology; HbA1c, hemoglobin A1c; BMI, body mass index."

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