Cumulative burden of diabetes-related complications and health-related quality of life in primary care: a cross-sectional study from Mexico

TL;DR

This study from Mexico shows that diabetes complications are common and significantly impact patients' quality of life, especially as complications accumulate.

Contribution

The study provides new insights into the cumulative burden of diabetes complications and their specific effects on health-related quality of life in primary care settings.

Findings

70.5% of patients had at least one diabetes-related complication, with peripheral neuropathy being the most common.

Pain/discomfort and anxiety/depression were the most affected HRQoL dimensions, each reported by over 50% of patients.

Female sex, longer diabetes duration, and insulin use were key factors associated with impaired HRQoL.

Abstract

Understanding the coexistence of diabetes-related complications and their impact on quality of life can help guide healthcare strategies.

The purpose of this study was to assess the prevalence and coexistence of diabetes-related complications and their association with health-related quality of life (HRQoL) in patients with type 2 diabetes (T2D).

We conducted a cross-sectional study of 1,703 patients with T2D receiving standard care in primary healthcare units in Mexico. Diabetes-related complications assessed included peripheral neuropathy, retinopathy, chronic kidney disease, cardiovascular disease, and amputation history. HRQoL was measured using the EuroQol 5-Dimension 5-Level questionnaire. Multivariable regression analyses were used to adjust for confounders and assess associations with HRQoL.

Complications were present in 70.5% of patients, predominantly peripheral neuropathy. The most affected HRQoL dimensions were pain/discomfort (53.8%) and anxiety/depression (53.4%), followed by mobility (34.2%), self-care (34%), and usual activities (24.2%). Multivariable analysis showed female sex was independently associated with a higher likelihoodof reporting problems across all dimensions. Having at least one complication was also associated with impairment, except for anxiety/depression, where risk increased with two or more complications. Hypertension and use of insulin were associated with a higher risk of problems in mobility, selfcare, and usual activities. Longer diabetes duration and use of insulin were risk factors for pain/discomfort, while higher body mass index was associated with anxiety/depression.

Diabetes-related complications are highly prevalent and affect HRQoL domains in primary care, with a greater burden as complications accumulate.

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