title: Assessment of health-related quality of life of Bangladeshi patients with type 2 diabetes using the EQ-5D: a cross-sectional study.
abstract: BACKGROUND
  The management of diabetes requires a fundamental change in the lifestyle of patients, and one of the important outcome criteria is the quality of life. We assessed the health-related quality of life (HR-QoL) and examined the factors associated with it in type 2 diabetes.
  
  
  METHODS
  An analytical cross-sectional study was conducted among 500 type 2 diabetes patients (age >25 years and duration of diabetes >1 year). They were selected conveniently from the Out-Patient department of the Bangladesh Institute of Health Sciences Hospital. The HR-QoL was assessed using an adapted and validated Bangla version of the EQ-5D (© 1990 EuroQol Group. EQ-5D™) questionnaire. It has five domains: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression and two levels (problem and no problem) on each dimension. The responses to the EQ-5D were further translated into a single summary EQ-5D index using the UK TTO value set.
  
  
  RESULTS
  Of the patients, 50.2% were female, and 49.4% were aged >55 years. Only 28.4% had completed higher secondary education, and 50.8% were from lower-middle-income families. Around 78.8% either had overweight or were obese. About 50.4% had problems in mobility, 28.2% in self-care, 47.6% in usual activities, 72.8% in pain/discomfort, and 73.6% in anxiety/depression. Results of binary logistic regression analysis showed that age, gender, lower-middle income, and HbA1C were significantly (p < 0.05) associated with mobility. Self-care was significantly (p < 0.05) related to age, family history and duration of diabetes mellitus (DM). Gender, family history of DM, and lower-middle income had a significant (p < 0.05) association with usual activities. Pain was significantly (p < 0.05) associated with age, lower-middle income, and upper-middle income. Rural area, higher education, and HbA1C were significantly (p < 0.05) related to anxiety. Results of multiple linear regression analysis showed that age (p = 0.0001), female gender (p = 0.0001), and prescribed treatment (p = 0.048) were associated with the EQ-5D index.
  
  
  CONCLUSIONS
  The large majority (73%) of the patients had problems in pain/discomfort and anxiety/depression; 50% had problems in mobility and usual activities; and three in ten in self-care. Age, female gender, income, education, family history and duration of DM, and prescribed treatment are important factors that are associated with the HR-QoL in type 2 diabetes.
authors.affiliation: Department of Community Nutrition, Bangladesh University of Health Sciences (BUHS), 125/1 Darussalam Mirpur 1, Dhaka, 1216, Bangladesh. farzanasaleh_sumona@yahoo.com.
authors.forename: Farzana
authors.initials: F
authors.lastname: Saleh
authors.affiliation: BRAC Institute of Global Health, BRAC University, icddr,b campus, 68 Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212, Bangladesh. uf_ara@yahoo.com.
authors.forename: Ferdous
authors.initials: F
authors.lastname: Ara
authors.affiliation: Department of Epidemiology, BUHS, Dhaka, Bangladesh. shirinmumu@yahoo.com.
authors.forename: Shirin Jahan
authors.initials: SJ
authors.lastname: Mumu
authors.affiliation: Department of Biostatistics, BUHS, Dhaka, Bangladesh. mahafez47@gmail.com.
authors.forename: Md Abdul
authors.initials: MA
authors.lastname: Hafez
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D011795:Surveys and Questionnaires