Health-related Quality of Life in Patients with Type 2 Diabetes Mellitus: A Primary Care Multicenter Study

Abstract

Introduction: Type 2 diabetes mellitus (DM2) represents a significant challenge for health-related quality of life (HRQoL), which is influenced by sociodemographic and clinical factors. Objective: To evaluate HRQoL in patients with type 2 diabetes mellitus and analyze its relationship with sociodemographic and clinical variables, providing data for more comprehensive disease management. Methods: A multicenter cross-sectional study was conducted with 230 patients over 18 years of age in the primary care clinic of three hospitals in Mexico in 2024. HRQoL was measured with the Diabetes-39 (D-39) instrument, adjusted to 36 items after psychometric validation. Differences were analyzed according to age, sex, marital status, socioeconomic level, time of evolution, insulin use, and hospital using nonparametric tests (Mann-Whitney U and Kruskal-Wallis H). Results: The overall median HRQoL was 24.54 (0-100 scale; a higher score indicates worse HRQoL), with a mean of 29.14 (SD 18.91). Young adults (25-44 years) reported better HRQoL (median 80.56) than older adults (>60 years, 69.68; p=0.006). High socioeconomic status (91.20) exceeded low socioeconomic status (71.30; p=0.002). Patients with insulin showed worse HRQoL (69.91) than those without insulin (78.47; p<0.001). La Carlota Hospital had better HRQoL (77.78) than other centers (p=0.034). Conclusion: HRQoL varies significantly by age, socioeconomic status, insulin use, and hospital setting, highlighting the need for personalized interventions that consider clinical parameters such as glycemic control, assess the impact of T2DM on quality of life, and comprehensively address its determinants.