Health-related quality of life among patients with type 2 diabetes mellitus in Eastern Province, Saudi Arabia: A cross-sectional study

Autoři: Dhfer Alshayban aff001;  Royes Joseph aff001
Působiště autorů: Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia aff001
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227573


Diabetes mellitus has reached epidemic levels, and it threatens the economy and health globally and Saudi Arabia in particular. The study assessed health-related quality of life using EuroQol instrument and its predictors among patients with Type 2 diabetes mellitus in Eastern Province, Saudi Arabia. A cross-sectional study was conducted among 378 patients with Type 2 diabetes mellitus from two major health centers in Eastern Province. The study showed moderate health-related quality of life, as reported by the median index score of 0.808 with more than a quarter of patients with severe-extreme health state in some or all domains. Multiple-regression models showed that male gender, high monthly income, having no diabetes-related complications and having random blood glucose level less than 200 mg/dl were prone to have a higher index score compared to the corresponding contrary groups. The study will help in guiding the development of effective intervention programs to improve diabetes-related health-related quality of life among the Saudi population.

Klíčová slova:

Blood sugar – Diabetes mellitus – Glucose – Insulin – Medical education – Quality of life – Saudi Arabia – Socioeconomic aspects of health


1. International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: 2017.

2. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 2017;14:88–98. doi: 10.1038/nrendo.2017.151 29219149

3. World Health Organization. Global Health Estimates 2016: Disease burden by Cause, Age, Sex, by Country and by Region, 2000–2016. Geneva: World Health Organization; 2018.

4. Alneami YM, Coleman CL. Risk Factors for and Barriers to Control Type-2 Diabetes among Saudi Population. Glob J Health Sci 2016;8:54089. doi: 10.5539/gjhs.v8n9p10 27157156

5. Robert A, Al Dawish M, Braham R, Musallam M, Al Hayek A, Al Kahtany N. Type 2 Diabetes Mellitus in Saudi Arabia: Major Challenges and Possible Solutions. Curr Diabetes Rev 2016;13:59–64. doi: 10.2174/1573399812666160126142605 26813972

6. World Health Organization. Global report on diabetes. Geneva: World Health Organization; 2017.

7. Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016;388:1459–544. doi: 10.1016/S0140-6736(16)31012-1 27733281

8. Fitzpatrick R, Fletcher A, Gore S, Jones D, Spiegelhalter D, Cox D. Quality of life measures in health care. I: Applications and issues in assessment. BMJ 1992;305:1074–7. doi: 10.1136/bmj.305.6861.1074 1467690

9. van der Vinne E. The ultimate goal of disease management: improved quality of life by patient centric care. Int J Integr Care 2009;9:e89. doi: 10.5334/ijic.321 19777113

10. Mokdad AH, Tuffaha M, Hanlon M, El Bcheraoui C, Daoud F, Al Saeedi M, et al. Cost of Diabetes in the Kingdom of Saudi Arabia. J Diabetes Metab 2015;6:575.

11. Al-Aboudi IS, Hassali MA, Shafie AA, Hassan A, Alrasheedy AA. A cross-sectional assessment of health-related quality of life among type 2 diabetes patients in Riyadh, Saudi Arabia. SAGE Open Med 2015;3:2050312115610129. doi: 10.1177/2050312115610129 26770806

12. Al Hayek AA, Robert AA, Al Saeed A, Alzaid AA, Al Sabaan FS. Factors Associated with Health-Related Quality of Life among Saudi Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Survey. Diabetes Metab J 2014;38:220. doi: 10.4093/dmj.2014.38.3.220 25003076

13. Elazhary H, Noorwali A, Zaidi N, Alshamrani R, Aljohani M, Khan D, et al. Knowledge about Diabetes and Its Effect on Quality of Life among Diabetic Patients in King Abdulaziz University Hospital, Jeddah. J Adv Med Med Res 2018;26:1–11. doi: 10.9734/JAMMR/2018/40083

14. Jarab AS, Alefishat E, Mukattash TL, Albawab AQ, Abu-Farha RK, McElnay JC. Exploring variables associated with poor health-related quality of life in patients with type 2 diabetes in Jordan. J Pharm Heal Serv Res 2018. doi: 10.1111/jphs.12255

15. Al-Maskari MY, Al-Shookri AO, Al-Adawi SH, Lin KG, Al-Shookri A. Assessment of quality of life in patients with type 2 diabetes mellitus in Oman. Saudi Med J 2011;32:1285–90. 22159385

16. Bani-Issa W. Evaluation of the health-related quality of life of Emirati people with diabetes: integration of sociodemographic and disease-related variables. East Mediterr Heal J 2011;17:825–30.

17. Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World J Diabetes 2017;8:120–9. doi: 10.4239/wjd.v8.i4.120 28465788

18. Safita N, Islam SMS, Chow CK, Niessen L, Lechner A, Holle R, et al. The impact of type 2 diabetes on health related quality of life in Bangladesh: results from a matched study comparing treated cases with non-diabetic controls. Health Qual Life Outcomes 2016;14:129. doi: 10.1186/s12955-016-0530-7 27624600

19. Sakamaki H, Ikeda S, Ikegami N, Uchigata Y, Iwamoto Y, Origasa H, et al. Measurement of HRQL Using EQ-5D in Patients with Type 2 Diabetes Mellitus in Japan. Value Heal 2006;9:47–53. doi: 10.1111/j.1524-4733.2006.00080.x 16441524

20. EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 1990;16:199–208. doi: 10.1016/0168-8510(90)90421-9 10109801

21. Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health-related quality of life: An EQ-5D-5L value set for England. Health Econ 2018;27:7–22. doi: 10.1002/hec.3564 28833869

22. Bekairy AM, Bustami RT, Almotairi M, Jarab A, Katheri AM, Aldebasi TM, et al. Validity and reliability of the Arabic version of the the EuroQOL (EQ-5D). A study from Saudi Arabia. Int J Health Sci (Qassim) 2018;12:16–20.

23. Aburuz S, Bulatova N, Twalbeh M, Gazawi M. The validity and reliability of the Arabic version of the EQ-5D: a study from Jordan. Ann Saudi Med 2009;29:304–8. doi: 10.4103/0256-4947.55313 19584581

24. Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 2011;20:1727–36. doi: 10.1007/s11136-011-9903-x 21479777

25. Moradi-Lakeh M, Forouzanfar MH, El Bcheraoui C, Daoud F, Afshin A, Hanson SW, et al. High Fasting Plasma Glucose, Diabetes, and Its Risk Factors in the Eastern Mediterranean Region, 1990–2013: Findings From the Global Burden of Disease Study 2013. Diabetes Care 2017;40:22–9. doi: 10.2337/dc16-1075 27797926

26. Sherif S, Sumpio BE. Economic development and diabetes prevalence in MENA countries: Egypt and Saudi Arabia comparison. World J Diabetes 2015;6:304–11. doi: 10.4239/wjd.v6.i2.304 25789111

27. Pan C-W, Sun H-P, Wang X, Ma Q, Xu Y, Luo N, et al. The EQ-5D-5L index score is more discriminative than the EQ-5D-3L index score in diabetes patients. Qual Life Res 2015;24:1767–74. doi: 10.1007/s11136-014-0902-6 25540029

28. Al-Aboudi IS, Hassali MA, Shafie AA. Knowledge, attitudes, and quality of life of type 2 diabetes patients in Riyadh, Saudi Arabia. J Pharm Bioallied Sci 2016;8:195–202. doi: 10.4103/0975-7406.171683 27413347

29. Al-Shehri AH, Taha AZ, Bahnassy AA, Salah M. Health-related quality of life in type 2 diabetic patients. Ann Saudi Med 2008;28:352–60. doi: 10.5144/0256-4947.2008.352 18779640

30. Quah JHM, Luo N, Ng WY, How CH, Tay EG. Health-related quality of life is associated with diabetic complications, but not with short-term diabetic control in primary care. Ann Acad Med Singapore 2011;40:276–86. 21779616

31. Redekop WK, Koopmanschap MA, Stolk RP, Rutten GEHM, Wolffenbuttel BHR, Niessen LW. ealth-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care 2002;25:458–63. doi: 10.2337/diacare.25.3.458 11874930

32. Lee WJ, Song K-H, Noh JH, Choi YJ, Jo M-W. Health-Related Quality of Life Using the EuroQol 5D Questionnaire in Korean Patients with Type 2 Diabetes. J Korean Med Sci 2012;27:255. doi: 10.3346/jkms.2012.27.3.255 22379335

33. Unden A, Elofsson S, Andreasson A, Hillered E, Eriksson I, Brismar K. Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes. Gend Med 2008;5:162–80. doi: 10.1016/j.genm.2008.05.003 18573483

34. Sharara E, Akik C, Ghattas H, Makhlouf Obermeyer C. Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature. BMC Public Health 2018;18:639. doi: 10.1186/s12889-018-5472-z 29776343

35. Al Senany S, Al Saif A. Assessment of physical health status and quality of life among Saudi older adults. J Phys Ther Sci 2015;27:1691–5. doi: 10.1589/jpts.27.1691 26180299

36. Khoja AT, Aljawadi MH, Al-Shammari SA, Mohamed AG, Al-Manaa HA, Morlock L, et al. The health of Saudi older adults; results from the Saudi National Survey for Elderly Health (SNSEH) 2006–2015. Saudi Pharm J 2018;26:292–300. doi: 10.1016/j.jsps.2017.11.008 30166931

37. Mielck A, Vogelmann M, Leidl R. Health-related quality of life and socioeconomic status: inequalities among adults with a chronic disease. Health Qual Life Outcomes 2014;12:58. doi: 10.1186/1477-7525-12-58 24761773

38. Robert SA, Cherepanov D, Palta M, Dunham NC, Feeny D, Fryback DG. Socioeconomic Status and Age Variations in Health-Related Quality of Life: Results From the National Health Measurement Study. Journals Gerontol Ser B Psychol Sci Soc Sci 2009;64B:378–89. doi: 10.1093/geronb/gbp012 19307286

39. Ishii H, Terauchi Y, Jinnouchi H, Taketsuna M, Takeuchi M, Imaoka T. Effects of insulin changes on quality of life and glycemic control in Japanese patients with type 2 diabetes mellitus: The insulin-changing study intending to gain patients’ insights into insulin treatment with patient-reported health outcomes in actual c. J Diabetes Investig 2013;4:560–70.

40. Home P, Riddle M, Cefalu WT, Bailey CJ, Bretzel RG, Del Prato S, et al. Insulin therapy in people with type 2 diabetes: opportunities and challenges? Diabetes Care 2014;37:1499–508. doi: 10.2337/dc13-2743 24855154

41. Navicharern R. Diabetes self-management, fasting blood sugar and quality of life among type 2 diabetic patients with foot ulcers. J Med Assoc Thai 2012;95:156–62. 22435243

42. Scollan-Koliopoulos M, Bleich D, Rapp KJ, Wong P, Hofmann CJ, Raghuwanshi M. Health-Related Quality of Life, Disease Severity, and Anticipated Trajectory of Diabetes. Diabetes Educ 2013;39:83–91. doi: 10.1177/0145721712467697 23174664

43. Kayo AR, Wimala AR, Angela N, Rashid IA. Random blood glucose level as predictor of cognitive impairment in elderly. Univ Med 2012;31:131–9.

44. Parsa P, Ahmadinia-Tabesh R, Mohammadi Y, Khorami N. Investigating the relationship between quality of life with lipid and glucose levels in Iranian diabetic patients. Diabetes Metab Syndr Clin Res Rev 2017;11:S879–83. doi: 10.1016/J.DSX.2017.07.009 28755844

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2020 Číslo 1