DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161220

Health-related quality of life and factors affecting it in type-2 diabetic nephropathy patients: a cross sectional observational study

Raghuvansh Kumar, Pawan Krishan, Roopkamal Jhajj

Abstract


Background: Diabetes is known to worsen the health related quality of life (HRQoL). The aim of the study was to analyze a comprehensive set of potential determinants of HRQoL in a sample of patients suffering from diabetic nephropathy.

Method: 60 patients were enrolled and divided into different groups on the basis of stage of diabetic nephropathy. HRQoL was evaluated using generic and disease- specific questionnaires. Generic instrument included SF-36 and diseases-specific instruments used were D-39 (Diabetes-39) and ADS (appraisal diabetes scale). The scores of these questionnaires were analyzed for their association with various demographic factors.

Results: It was observed that quality of life deteriorated with the progression of diabetic nephropathy. On the basis of SF-36 score HRQoL was found to be dependent on, age, HbA1c level, presence of positive family history of diabetes and alcohol consumption. On the other hand D-39 scores showed significant association between HRQoL and various demographic factors such as gender, blood pressure, alcoholic consumption and blood sugar levels. According to ADS scores, HRQoL showed association with alcohol consumption and blood sugar levels.

Discussion: HRQoL is associated with multiple factors but high linkage is demonstrated by socio-demographic factors and diabetic complications. A patient centred approach should be helpful to prevent deterioration of HRQoL and thus will decrease the burden of diabetes. A regular checkup and early detection of diabetic nephropathy and its management could further delay the decline in quality of life of these patients.


Keywords


Health related quality of life, Appraisal diabetes scale, Diabetes 39 questionnaire, Diabetic nephropathy, Short form -36 questionnaire (SF-36)

Full Text:

PDF

References


Vasavada N, Agarwal R. Role of oxidative stress in diabetic nephropathy. Adv Chronic Kidney Dis. 2005;12:146-54.

Lee WJ, Song KH, Noh JH, Choi YJ, Jo MW. Health-related quality of life using the EuroQol 5D questionnaire in Korean patients with type 2 diabetes. J Korean Med ScI.2012;27:255-60.

Schunk M, Reitmeir P, Schipf S, Volzke H, Meisinger C, Thorand B et al. Health related quality of life in subjects with and without type 2 diabetes: pooled analysis of five population-based surveys in Germany. Diabet Med. 2012;29:646-53.

Wang HF, Yeh MC. The quality of life of adults with type 2 diabetes in a hospital care clinic in Taiwan. Qual Life Res. 2013;22:577-84.

Kleefstra N, Landman GWD, Houweling ST, Ubink-Veltmaat LJ, Logtenberg SJJ, Meyboom-de Jong B. Prediction of mortality in type 2 diabetes from health-related quality of life (ZODIAC-4). Diabetes Care. 2008;31:932-3.

Rasekaba TM, Graco M, Risteski C, Jasper A, Berlowitz DJ, Hawthorne G. Impact of a diabetes disease management program on diabetes control and patient quality of life. Popul Health Manag. 2012;15:12-9.

Pera PI. Living with diabetes: quality of care and quality of life. Patient Prefer Adherence. 2011;5:65-72.

Farquhar M. Definitions of quality of life: a taxonomy. J AdvNurs. 1995;22:502-8.

Mcewen LN, Kim C, Haan MN, Ghosh D, Lantz PM, Thompson TJ et al. Are health-related quality-of-life and self-rated health associated with mortality? Insights from Translating Research Into Action for Diabetes (TRIAD). Prim Care Diabetes. 2009;3:37-42.

Hanninen J, Takala J, Kiukaanniemi SK. Quality of life in NIDDM patients assessed with the SF-20 questionnaire. Diabetes Res ClinPract. 1998;42:17-27.

Testa MA, Simonson D. Assessment of quality-of-life outcomes. N Engl J Med. 1998;334:835-40.

Kitada M, Kume S, Watanabe AT, Kanasaki K, Koya D. Sirtuins and renal diseases: relationship with aging and diabetic nephropathy. ClinSci (Lond). 2013;124:153-64.

Coffey JT, Brandle M, Zhou H, Marriott D, Burke R, Tabaei BP et al. Valuing Health-Related Quality of Life in Diabetes. Diabetes Care. 2002;25:2238-43.

Rehman G, Khan SA, Hamayun M. Studies on diabetic nephropathy and secondary diseases in type 2 diabetes. Int J Diab Dev Countries. 2005;25:25-29.

Usman A, Umar RA, Shehu NI, Wali U, Nasir A. Markers of diabetic nephropathy in diabetic patients in gusau, zamfara state, Nigeria. AJOL. 2012;20:130-3.

Ríos-Castillo JLDL, Sánchez JJ, Barrios-Santiago P, Ocampo-Mancilla M, Avila-Rojas TL. Quality of life in patients with diabetic nephropathy. Invest Educ Enferm. 2005;23:30-61.

Bosman DR, Winkler AS, Marsden JT, Macdougall IC, Watkins PJ. Anemia with erythropoietin deficiency occurs early in diabetic nephropathy. Diabetes Care. 2001;24:495-9.

Lyrakos G, Hatziagelaki E, Spinaris B, Damigos D, Spyropoulos I, Kostopanagiotou G. The comparison of fatigue between patients with diabetes melittus, psychiatric outpatients and general population in Greece. European Psychiatry. 2012;27(Suppl):1.

Glasgow RE, Ruggiero L, Eakin EG, Dryfoos J, Chobanian L. Quality of life and associated characteristics in a large national sample of adults with diabetes. Diabetes Care. 1997;20:562-7.

Gulliford MC, Mahabir D. Relationship of health-related quality of life to symptoms severity in diabetes mellitus: a study in Trinidad and Tobago. J Clin Epidemiol. 1999;52:773-80.

Connel CM, Dawis WK, Gallant MP, Sharpe PA. Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes. Health Psychol. 1994;13:263-73.

Pankevich DE, Wizemann T, Bruce M, Altevogt, Rapporteurs. Sex Differences and Implications for Translational Neuroscience Research: Workshop Summary 2011 [http://www.ncbi.nlm.nih.gov/books/NBK53385/pdf/TOC.pdf]

Hibbard JH, Pope CR. Gender roles illness orientation and use of medical services. Soc Sci Med. 1983;17:129-37.

Wredling R, Stalhammar J, Adamson U, Berne C, Larsson Y, Oestman J. Wellbeing and treatment satisfaction in adults with diabetes: a Swedish population based study. Qual Life Res. 1995;4:515-22.

Eiser C, Flynn M, Green E, Havermans T, Kirby R, Sandeman D, Tooke JE. Quality of life in young adults with type 1 diabetes in relation to demographic and disease variables. Diabet Med. 1992;9:375-8.

Ward J, Lin M, Heron G, Lajoje V. Comprehensive audit of quality-of-care and quality-of-life for patients with diabetes. J Qual Clin Prac. 1997;17:91-100.

Naughton MJ, Yi-Frazier JP, Morgan TM, Seid M, Lawrence JM, Klingensmith GJ et al. Longitudinal associations between sex, diabetes self-care, and health-related quality of life among youth with type 1 or type 2 diabetes mellitus. J Pediatr. 2014 164:1376-83.

Abhinav K, Amber L, Michael JS, Melissa FP, Richard LS, Aanand DN. Hemoglobin A1c improvements and better diabetes-specific quality of life among participants completing diabetes self-management programs: a nested cohort study. Health Qual Life Outcomes. 2012;10:1-7.

Chowdhury TA, Dyer PH, Kumar S, Barnett AH, Bain SC. Genetic determinants of diabetic nephropathy. Clin Sci (Lond). 1999;96:221-30.

UK prospective diabetes study group. Tight blood pressure control and risk of macro vascular and micro vascular complications in type 2 diabetes: UKPDS 38. Br Med J. 1998;317(7160):703-13.

Magwood GS, Zapka J, Jenkins C. A review of systematic reviews evaluating diabetes interventions; focus on quality of life and disparities. Diabetes Educ. 2008;34:242-65.

Nathan DM, Davidson MB, DeFronzo RA, Heine RJ, Henry RR, Pratley R. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care. 2007;30:753-9.

Gulliford MC, Mahabir D. Relationship of health-related quality of life to symptom severity in diabetes mellitus: a study in trinidad and tobago. J ClinEpidemiol. 1999;52:773-80.