title: Self-perception of health status, mental health and quality of life among adults with diabetes residing in a metropolitan area.
abstract: OBJECTIVE
  The study aimed to compare the self-perception of health, physiological distress and health-related quality of life (HRQL) in subjects with and without diabetes residing in a large metropolitan area (the city of Madrid), and to identify the variables associated with the poorest HRQL among diabetes patients.
  
  
  METHODS
  In this case-control epidemiological study, we selected 358 patients with diabetes from the Madrid City Health Survey. For every patient, two controls without diabetes were randomly selected from the same database and matched for age, gender and health district. The resultant study population comprised 1074 subjects, who were analyzed according to their self-rated health status, with mental health assessed by the 12-item General Health Questionnaire (GHQ-12) and HRQL by the COOP/WONCA questionnaire. Independent variables included sociodemographic characteristics, lifestyle variables, associated chronic diseases and consumption of medications. Multivariate analyses were conducted using ANCOVA tests.
  
  
  RESULTS
  The prevalence of health perceived as fair or poor was 64.12% in those with diabetes vs 38.57% in those without diabetes (P<0.05). The GHQ-12 results showed that mental health was also significantly worse among diabetes sufferers, and the COOP/WONCA questionnaire results indicated significantly poorer HRQL in those with diabetes. The variables that determined a poorer perception of HRQL among diabetes sufferers were female gender, older age, obesity, lack of physical exercise, coexistence of depression, use of sleeping pills, and Alzheimer's and cerebrovascular diseases.
  
  
  CONCLUSIONS
  Self-rated health and psychological well-being, and HRQL, are all considerably poorer among patients with diabetes vs those without diabetes. The poorest quality of life among those with diabetes associated with female gender, depression, lack of exercise and obesity.
authors.affiliation: Institute of Public Health, Madrid Health (Madrid Salud), Madrid City Council (Ayuntamiento de Madrid), Calle Juan Esplandiu, 11, 28007 Madrid, Spain.
authors.forename: M M
authors.initials: MM
authors.lastname: Esteban y Peña
authors.forename: V
authors.initials: V
authors.lastname: Hernandez Barrera
authors.forename: X
authors.initials: X
authors.lastname: Fernández Cordero
authors.forename: A
authors.initials: A
authors.lastname: Gil de Miguel
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez Pérez
authors.forename: A
authors.initials: A
authors.lastname: Lopez-de Andres
authors.forename: R
authors.initials: R
authors.lastname: Jiménez-García
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D011788:Quality of Life; D012111:Residence Characteristics; D012307:Risk Factors; D012649:Self Concept; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data*