Little is known about the association between diabetes and health related quality of life (HRQL) in lower-middle income countries. This study aimed to investigate HRQL among individuals with and without diabetes in Bangladesh.
The analysis is based on data of a case-control study, including 591 patients with type 2 diabetes (cases) who attended an outpatient unit of a hospital in Dhaka and 591 age -and sex-matched individuals without diabetes (controls). Information about socio-demographic characteristics, health conditions, and HRQL were assessed in a structured interview. HRQL was measured with the EuroQol (EQ) visual analogue scale (VAS) and the EQ five-dimensional (5D) descriptive system. The association between diabetes status and quality of life was examined using multiple linear and logistic regression models.
Mean EQ-VAS score of patients with diabetes was 11.5 points (95%-CI: -13.5, -9.6) lower compared to controls without diabetes. Patients with diabetes were more likely to report problems in all EQ-5D dimensions than controls, with the largest effect observed in the dimensions ‘self-care’ (OR= 5.9; 95%-CI: 2.9, 11.8) and ‘mobility’ (OR= 4.5; 95%-CI: 3.0, -6.6). In patients with diabetes, male gender, high education, and high-income were positively and diabetes duration and foot ulcer negatively associated with VAS scores. Other diabetes-related complications were not significantly associated with HRQL.
The burden of diabetes in Bangladesh is higher then what has been found in other Asian or Western populations and is weakly mediated by comorbidities. The high socio-economic burden of diabetes in Bangladesh might be the underlying issue that needs to be addressed.