Quality of Life of Patients with Diabetes Mellitus in a Nigerian Teaching Hospital

Article excerpt

Abstract

Objective: To assess the quality of life of patients with diabetes mellitus and to determine the clinical and sociodemographic factors that affect the quality of life of these patients.

Patients and Methods: This was a cross-sectional study of 251 patients with diabetes mellitus attending the University of Ilorin Teaching Hospital, Nigeria. The World Health Organization quality of life instrument, short version and a sociodemographic questionnaire was administered to assess quality of life.

Results: Most of the respondents performed fairly well on the World Health Organization quality of life instrument, short version. Poor quality of life was associated with some of the physical complications of diabetes mellitus, lower income, lower educational status, and type 2 diabetes mellitus.

Conclusions: Lower income, lower education, low-rated employment, and physical complications adversely affect the quality of life of patients with diabetes mellitus. Such factors need to be addressed by caregivers and physicians managing these patients.

Key words: Diabetes mellitus, Nigeria, Quality of life

Introduction

For most chronic illnesses, therapeutic success is traditionally measured by disease-free and overall survival, and control of major physical symptoms. While these factors play a primary role in such evaluations, efforts have been made to assess the extent to which chronic diseases and their treatments affect patients' functional capacity, psychological and social health, and overall sense of well-being or quality of life (QOL). (1)

The World Health Organization Quality of Life (WHOQOL) group defined QOL as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns. (2) This is a broad-ranging concept, affected in a complex way by a person's physical health, psychological state, level of independence, social relationships, and relationship to salient features of their environment. (3)

Diabetes mellitus is a typical chronic medical condition that places serious constraints on patients' activities. There is a need for extensive education and behaviour change to manage the condition. Lifestyle changes must incorporate careful dietary planning, eventual use of medication and, for all patients with type 1 diabetes and many with type 2 diabetes, the use of insulin and home blood glucose monitoring techniques. Diabetes mellitus may lead to serious multisystem complications that often require additional intrusive treatments. Diabetes mellitus is a useful model illness for considering the effects of chronic disease on health-related quality of life (HRQOL). (4)

Studies have shown variability in the QOL effects of type 1 and 2 diabetes. For example, Gafvels found that patients with diabetes mellitus more frequently lived alone and remained childless, participated in fewer social activities, and indicated less personal satisfaction than control patients. (5) Women appear to experience a greater impact of diabetes on their QOL and experience more worries about complications and hypoglycaemia than men. (6) Other studies have found that patients with diabetes mellitus have good QOL in comparison to those with some other chronic diseases and even to healthy populations. (7) Mayou et al (8) and Hanasted (9) reported that the majority of patients with type 1 and type 2 diabetes mellitus experience a high degree of well-being, satisfaction, and enjoyment, although a minority noted that aspects of their lives were negatively affected by both forms of diabetes mellitus. It appears that type 1 diabetes mellitus has a greater negative impact on QOL than type 2 disease. (10) These studies also indicated that the progression of diabetic complications is associated with a decrease in QOL.

The treatment of diabetes mellitus appears to have a complex effect on QOL. …