title: Relationship of the adherence to the Mediterranean diet with health-related quality of life and treatment satisfaction in patients with type 2 diabetes mellitus: a post-hoc analysis of a cross-sectional study.
abstract: OBJECTIVE
  The main aim of this study was to assess the association between adherence to the traditional Mediterranean diet (MedDiet) and health-related quality of life (HRQoL) and treatment satisfaction in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  This cross-sectional study included 294 patients with T2DM (146 with diabetic retinopathy and 148 without retinopathy). HRQoL and treatment satisfaction were assessed with the Audit Diabetes-Dependent Quality of Life and Diabetes Treatment Satisfaction Questionnaires, respectively. Adherence to the MedDiet was evaluated with the relative Mediterranean Diet Score (rMED). The rMED was added to multivariate linear regression models to assess its relative contribution as a quantitative as well as a qualitative variable after recoding to maximize each of the model's coefficients of determination to explain quality of life as well as treatment satisfaction dimensions.
  
  
  RESULTS
  The adherence to the Mediterranean diet showed no significant association with the overall quality of life score. However, rMED was associated with some HRQoL dimensions: travels, self-confidence and freedom to eat and drink (p = 0.020, p = 0.015, p = 0.037 and p = 0.015, respectively). Concerning treatment satisfaction, rMED was positively associated with its overall score (p = 0.046), and especially with the understanding of diabetes (p = 0.0004) and treatment recommendation (p = 0.036), as well as with the perceived frequency of hyperglycaemias (p = 0.039).
  
  
  CONCLUSIONS
  Adherence to the Mediterranean diet was associated with greater treatment satisfaction in patients with T2DM. Although we found no association with overall HRQoL, adherence to this dietary pattern was associated with some quality of life dimensions.
authors.affiliation: Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Alcubierre
authors.affiliation: Biostatistics Unit, Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Martinez-Alonso
authors.affiliation: Biostatistics Unit, Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Valls
authors.affiliation: Unitat de Suport a la Recerca de Barcelona, Institut Universitari d'Investigació en Atenció. Primària Jordi Gol (IDIAP Jordi Gol), CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, 08007, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Rubinat
authors.affiliation: Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.|Department of Ophthalmology, University Hospital Arnau de Vilanova, Lleida, 25198, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Traveset
authors.affiliation: Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.|Department of Endocrinology and Nutrition, University Hospital Arnau de Vilanova, Lleida, 25198, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Hernández
authors.affiliation: Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Martínez-González
authors.affiliation: Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.
authors.forename: Minerva
authors.initials: M
authors.lastname: Granado-Casas
authors.affiliation: Institut de Recerca Biomèdica de Lleida, University of Lleida, Lleida, 25198, Spain.|Department of Ophthalmology, University Hospital Arnau de Vilanova, Lleida, 25198, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Jurjo
authors.affiliation: Consortium for Biomedical Research in Epidemilogy and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Madrid, 28029, Spain.|Public Health Department, Miguel Hernandez University, Alicante, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Vioque
authors.affiliation: Consortium for Biomedical Research in Epidemilogy and Public Health (CIBER en Epidemiología y Salud Pública CIBERESP), Madrid, 28029, Spain.|Public Health Department, Miguel Hernandez University, Alicante, Spain.
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Navarrete-Muñoz
authors.affiliation: Unitat de Suport a la Recerca de Barcelona, Institut Universitari d'Investigació en Atenció. Primària Jordi Gol (IDIAP Jordi Gol), CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, 08007, Spain. didacmauricio@gmail.com.|Department of Endocrinology and Nutrition, University Hospital and Health Sciences Research Institute Germans Trias Pujol, CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Badalona, 08916, Spain. didacmauricio@gmail.com.
authors.forename: Didac
authors.initials: D
authors.lastname: Mauricio
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000523:psychology*; D038441:Diet, Mediterranean / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D012959:Socioeconomic Factors
keywords: Mediterranean diet; Quality of life; Relative Mediterranean Diet score; Treatment satisfaction; Type 2 diabetes mellitus