Type 2 diabetes and quality of life

Abstract

It is true that a primary goal of diabetes early diagnosis and treatment is quality of life (QoL). The term QoL is still confusing but it is agreed that it composes of four components: The physical component, mental, cogitative component, psychological and social component. Many articles have been written addressing those four components. During the last five years 15500 articles and reviews have been written addressing diabetes and coronary arterial disease, 16100 addressing diabetes and renal function, 28900 addressing diabetes and retinopathy, 16800 addressing diabetic foot ulcers and other 26300 addressing diabetic neuropathy. Moreover 17200 articles are dealing with diabetic sexual dysfunction, 24500 with the correlation of diabetes and depression 17500 about diabetes and dementia, only 1 about diabetes and family functioning and 1950000 about diabetes and QoL, indicating the worldwide interest. In order to confront this metabolic anomaly and its consequences, researchers developed numerous generic and disease specific psychometric tools. With the aid of those psychometric tools the scientific community has started to realize the gruesome effect of diabetes on patients’ lives. Diabetic’s QoL becomes worse when complications start to develop or comorbidities coexist. Dominant amongst complications, in health-related quality of life (HRQoL) lowering, but not related to risk factors (genetic, the weight of birth, or others) is coronary arterial disease followed by renal failure, blindness, and the combination of micro- and macro-vascular complications and in some studies by sexual dysfunction. Moreover many are the comorbidities which deteriorate further the effect of diabetes in a patient life. Among them obesity, hypertension, dyslipidemia, depression, arthritis are the most common. Most intriguing field for research is the interaction of diabetes and depression and in some cases the progression to dementia. Many aspects and combinations of actions are under researchers’ microscope regarding the improvement of HRQoL scores. Until now, the studies performed, have demonstrated little to moderate benefit. More of them are needed to draw safe conclusions on the topic of the best combination of actions to optimize the HRQoL scores.

Keywords: Type 2 diabetes; Quality of life; Diabetes co morbidities; Diabetes complications; Dementia; Diabetes type 3

Core tip: Although numerous articles and reviews are written about diabetes every year regarding epidemiology, complications, therapies, comparisons of treatments, health strategies, literature data on diabetic patient’s quality of life and how much it is actually affected by complications, comorbidities or different treatments are limited. The current review is focused on: (1) the way patients perceive the changes in different aspects of quality of their lives as recorded by numerous psychometric tools and scales; (2) on the similarities and differences among studies performed worldwide along with the problems and caveats in research; and (3) on aspects intriguing but demanding further research as the effect of diabetes in family life or the common metabolic pathways between diabetes and dementia (recently called also diabetes type 3).