Investigating correlates of health related quality of life in a low-income sample of patients with diabetes

Objective: We sought to describe and find correlates of health-related quality of life among under-served low-income patients in North Carolina with diabetes mellitus. Methods: A telephone survey of 310 patients recording quality of life, patient satisfaction, self-reported health, and patient complaints was conducted as part of a diabetes care improvement project. Demographic and clinical records were available for 249 of these patients: 69% were female, 45% were minority, and 84% had type 2 diabetes. Ages ranged from 18 to 88 years with a mean of 56. Quality of life indices consisted of SF-36 physical functioning, mental health and diabetes-39 sub-scores. Results: Comparison to SF-36 norms showed the sample had lower sub-scores than expected. The multivariate analysis suggested that being within an acceptable metabolic control predicted better quality of life physically, mentally, and sexually. Strong associations were detected between most sub-scores and complaints involving legs and feet, self-rated vision, and hassles in self-management. Conclusions: The consistent associations between the sub-scores and complaints, symptoms, and hassles underscore the strong relationship quality of life may share with the severity of diabetes complications as well as with psychosocial factors. Significantly lower quality of life in this sample highlights the need to improve the care of minority low-income diabetes patients.