QUALITY OF LIFE OF PATIENTS WITH TYPE 2 DIABETES MELLITUS
Keywords:
type 2 diabetes mellitus, quality of life, health literacy, diabetes distress, self-care, chronic complicationsAbstract
Type 2 diabetes mellitus is a chronic metabolic disease whose prevalence continues to increase, making it one of the leading public health challenges of the modern era. It is characterized by insulin resistance and progressive metabolic dysregulation, resulting in chronic hyperglycemia. Due to its long-term nature and the need for daily self-management, the disease significantly affects the physical, psychological, social, and functional aspects of patients’ lives. Consequently, contemporary therapeutic approaches have gradually shifted from an exclusive focus on glycemic control toward a more holistic model that includes the assessment and improvement of patients’ quality of life. Aim: To provide an overview of current evidence on the determinants of quality of life in individuals with type 2 diabetes mellitus, emphasizing the role of health literacy, psychological factors, sociodemographic characteristics, and diabetes-related clinical complications. Methods: This paper is based on a narrative review of the available scientific literature. Relevant studies were identified through searches of electronic databases (PubMed, Scopus, Web of Science, and Google Scholar) following the PRISMA guidelines. Studies examining health-related quality of life (HRQoL) among adults with type 2 diabetes mellitus were considered eligible. A total of eight original research articles published in 2024 were included in the final analysis. Results: The reviewed studies indicate that most patients perceive their quality of life as moderate. A strong positive association is identified between health literacy and quality of life, with higher levels of health literacy contributing to better self-care and adherence to therapeutic recommendations, which emerged as the strongest predictors of a good quality of life. Conversely, psychological factors such as depression, anxiety, and diabetes distress, as well as clinical factors including disease duration, insulin therapy, and microvascular and macrovascular complications (e.g., peripheral neuropathy and heart failure), were found to significantly impair daily functioning and reduce the quality of life. Furthermore, older age, lower educational attainment, and poorer socioeconomic status were associated with less favorable outcomes.
Quality of life among individuals with type 2 diabetes mellitus is a complex construct influenced by the interaction of clinical, psychological, and behavioral determinants. Improving the quality of life requires a multidisciplinary approach that extends beyond pharmacological treatment alone. The integration of structured health literacy programs, continuous self-management education, psychological support, and the strengthening of social support networks represents an essential strategy for reducing emotional burden, improving disease management, and enhancing overall well-being and the quality of life in the long term.
References
Al-Qerem, W., Jarab, A., Hammad, A., Eberhardt, J., Alasmari, F., Alkaee, S. M., Alsabaa, Z. H., & Al-Ibadah, M. (2024). The association between health literacy and quality of life of patients with type 2 diabetes mellitus: A cross-sectional study. PLoS ONE, 19(10), Article e0132833. https://doi.org/10.1371/journal.pone.0312833
Albai, O., Braha, A., Timar, B., & Timar, R. (2024). Predictive factors for altered quality of life in patients with type 2 diabetes mellitus. Journal of Clinical Medicine, 13(15), Article 4389. https://doi.org/10.3390/jcm13154389
Almubaid, Z., Alhaj, Z., Almosa, O., Marikh, M., & Khan, W. (2024). The impact of social support on health outcomes of diabetic patients: A systematic review. Cureus, 16(8), Article e67842. https://doi.org/10.7759/cureus.67842
Alsaraireh, M., Al-Kalaldeh, M., Alnawafleh, K., Dwairej, D., & Almagharbeh, W. (2024). Associated factors influencing quality of life and knowledge among type 2 diabetic patients: A cross-sectional study. Current Diabetes Reviews, 21(2), Article e090224226838. https://doi.org/10.2174/0115733998284163240129073837
Alsayed Hassan, D., Helaluddin, F., Chahestani, O. H., Mohamed, O., & Islam, N. (2022). Diabetes self-management and health-related quality of life among primary care patients with diabetes in Qatar: A cross-sectional study. Healthcare, 10(11), Article 2124. https://doi.org/10.3390/healthcare10112124
American Diabetes Association. (2024). Standards of care in diabetes—2024. Diabetes Care, 47(Suppl. 1), S1–S321. https://doi.org/10.2337/dc24-S001
Bailey, S. C., Brega, A. G., Crutchfield, T. M., Elasy, T., Herr, H., Kaphingst, K., Karter, J. A., Moreland-Russell, S., Osborn, C. Y., Pignone, M., Rothman, R., & Schillinger, D. (2014). Update on health literacy and diabetes. The Diabetes Educator, 40(5), 581–604. https://doi.org/10.1177/0145721714540220
Davies, M. J., Aroda, V. R., Collins, B. S., Gabbay, R. A., Green, J., Maruthur, N. M., Rosas, S. E., Del Prato, S., Mathieu, C., Mingrone, G., Rossing, P., Tankova, T., Tsapas, A., & Buse, B. J. (2022). Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia, 65(12), 1925–1966. https://doi.org/10.1007/s00125-022-05787-2
Ekekezie, O. O., Mogboyinola, O. A., & Olatona, F. A. (2025). A cross-sectional study on the quality of life of patients with type 2 diabetes attending a General Hospital in Lagos State. Pan African Medical Journal, 51, Article 92. https://doi.org/10.11604/pamj.2025.51.92.45529
Esubalew, H., Belachew, A., Seid, Y., Wondmagegn, H., Temesgen, K., & Ayele, T. (2024). Health-related quality of life among type 2 diabetes mellitus patients using the 36-item Short Form Health Survey (SF-36) in Central Ethiopia: A multicenter study. Diabetes, Metabolic Syndrome and Obesity, 17, 1039–1049. https://doi.org/10.2147/DMSO.S448950
Forestier, B., Anthoine, E., Reguiai, Z., Fohrer, C., & Blanchin, M. (2019). A systematic review of dimensions evaluating patient experience in chronic illness. Health and Quality of Life Outcomes, 17(1), Article 19. https://doi.org/10.1186/s12955-019-1084-2
GBD 2021 Diabetes Collaborators. (2023). Global burden of diabetes and its complications. The Lancet, 402(10409), 203–221. https://doi.org/10.1016/S0140-6736(23)01301-6
Hadush, F., Beedemariam, G., Kahissay, M. H., Patel, S. A., & Habte, B. M. (2024). Patients' perceptions and knowledge of diabetes and medications: Implications for medication adherence and glycemic control in type 2 diabetes patients, Northern Ethiopia. Journal of Diabetes Research, 2024, Article 3652855. https://doi.org/10.1155/2024/3652855
International Diabetes Federation. (2021). IDF diabetes atlas (10th ed.). International Diabetes Federation.
Izadi, N., Shafiee, A., Niknam, M., Yari-Boroujeni, R., Azizi, F., & Amiri, P. (2024). Socio-behavioral determinants of health-related quality of life among patients with type 2 diabetes: Comparison between 2015 and 2018. BMC Endocrine Disorders, 24(1), Article 73. https://doi.org/10.1186/s12902-024-01604-6
Jafari, A., Naddafi, F., Gholian-Aval, M., & Tehrani, H. (2024a). Relationship between diabetes health literacy, distress, burnout, social support, complications, self-care behaviors, and quality of life among patients with type 2 diabetes: A path analysis study. Diabetology & Metabolic Syndrome, 16(1), Article 150. https://doi.org/10.1186/s13098-024-01391-z
Jafari, A., Moshki, M., Ghelichi-Ghojogh, M., & Nejatian, M. (2024b). Role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting quality of life in type 2 diabetes. Scientific Reports, 14(1), Article 1635. https://doi.org/10.1038/s41598-024-51245-x
Jenkinson, E., Knoop, J., Hudson, J. L., Moss-Morris, R., & Hackett, R. A. (2022). The effectiveness of cognitive behavioural therapy and third-wave cognitive behavioural interventions on diabetes-related distress: A systematic review and meta-analysis. Diabetic Medicine, 39(11), Article e14948. https://doi.org/10.1111/dme.14948
Nutbeam, D. (2025). Health literacy as a public health goal: 25 years on. Health Promotion International, 40(4), Article daaf119. https://doi.org/10.1093/heapro/daaf119
Perrin, N. E., Davies, M. J., Robertson, N., Snoek, F. J., & Khunti, K. (2017). The prevalence of diabetes-specific emotional distress in people with type 2 diabetes: A systematic review and meta-analysis. Diabetic Medicine, 34(11), 1508–1520. https://doi.org/10.1111/dme.13448
Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., Uelmen, S., & American Diabetes Association. (2020). Diabetes self-management education and support in adults with type 2 diabetes: A consensus report. Diabetes Care, 43(7), 1636–1649. https://doi.org/10.2337/dci20-0023
Ritonga, E., Utami, A. T., Yusdianti, A. N., Gondodiputro, S., Soetedjo, N. N., Alisjahbana, B., & Permana, H. (2025). Quality of life and diabetic complications among type 2 diabetes patients across healthcare levels in Bandung, Indonesia. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 19(1), Article 103142. https://doi.org/10.2147/DMSO.S549279
Salah, H. A., & Al-Abedi, H. A. (2024). Identification of quality of life for patients with type II diabetes mellitus. Pakistan Journal of Medical and Health Sciences, 18(1), 45–50. https://doi.org/10.57238/jbb.2024.7432.1127
Speight, J., Hendrieckx, C., Pouwer, F., & Skinner, T. C. (2020). Back to the future: 25 years of "Guidelines for encouraging psychological well-being" among people affected by diabetes. Diabetic Medicine, 37(8), 1225–1229. https://doi.org/10.1111/dme.14165
Tan, J. P. Y., Seah, S. J., Harding, S. C., Pua, J. Y., Wang, J., Aw, S., Lim, J., & Boon Tar Lim, R. (2022). Exploring the perspective of diabetes self-management and quality of life among older adults with type 2 diabetes: A qualitative study before and during the COVID-19 pandemic. Science of Diabetes Self-Management and Care, 48(3), 163–173. https://doi.org/10.1177/26350106221094527
Teli, M., Thato, R., & Rias, Y. A. (2023). Predicting factors of health-related quality of life among adults with type 2 diabetes: A systematic review. SAGE Open Nursing, 9, 1–15. https://doi.org/10.1177/23779608231185921
World Health Organization. (2023). Diabetes fact sheet. World Health Organization.
