Determinants of health-related quality of life of patients with type 2 diabetes and multimorbidity: a cross-sectional study

Abstract

Abstract Purpose To examine the determinants of health-related quality of life (HRQoL) of patients with type 2 diabetes (T2D) and multimorbidity (MM) (at least one co-occurring condition besides T2D) among socio-demographic, disease-related and MM variables and the association of MM with therapeutic targets. Methods A total of 179 people with T2D attending primary care (PC) in Greece answered the 15 Dimension (15D) questionnaire between August 2019 and October 2020. Socio-demographic, disease-related and MM characteristics were recorded. MM was categorized as concordant or discordant whether or not was related to the pathophysiology of T2D. Independent predictors of the 15D score were examined in stepwise regression models among socio-demographic, disease-related and MM variables and the association of MM with glycated haemoglobin (A1C) and low-density lipoprotein cholesterol (LDL-C) was assessed. Results The mean 15D score was 0.85 ± 0.11 and the mean MM count was 4.3 ± 1.8. Significant predictors of higher 15D score were male gender, married state, higher monthly income and more physical activity. Significant predictors of lower 15D score were employment, depression, musculoskeletal disease, coronary artery disease, neuropathy and MM count but discordant MM had a more prominent effect. MM count was not significantly correlated with A1C and was correlated with lower LDL-C levels. Conclusion Socio-demographic rather than disease-related characteristics and discordant more than concordant co-occurring conditions affected HRQoL of multimorbid patients with T2D how did not have worse (A1C) or achieved better (LDL-C) therapeutic targets. A generalist approach in T2D could be supported in PC within the social determinants of health and MM.