Health-related quality of life and its determinants among patients with diabetes mellitus: a multicentre cross-sectional study in Northwest Ethiopia

BMJ Open. 2023 Jan 25;13(1):e068518. doi: 10.1136/bmjopen-2022-068518.


Objectives: This study assessed the health-related quality of life (HRQoL) and its determinants in patients with diabetes.

Design and setting: An institutional-based multicentre prospective cross-sectional study design was conducted in diabetes follow-up clinics of selected hospitals in Northwest Ethiopia from April to July 2022.

Participants: All eligible adult patients with diabetes at the selected facilities.

Main outcome measures: HRQoL was measured using EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the EuroQol-Visual Analogue Scales (EQ-VAS) instruments. A lower EQ-5D-5L utility mean score for each dimension and/or an overall lower utility score of EQ-5D-5L and EQ-VAS scores are intended to show poor HRQoL. Linear regression analysis was used to identify the association of HRQoL and other variables.

Results: Out of the 422 samples approached, 402 (95.3%) participated in the study. Most of the participants (>85%) reported having moderate-to-severe problems in all five EQ dimensions. The overall EQ-5D-5L utility and EQ-VAS scores were 0.56 (±0.11) and 56.7 (±10.1), respectively. A higher body mass index (BMI) (p < 0.001), a higher number of medications (p = 0.037), a high level of blood glucose (p < 0.001), the presence of comorbidities and/or complications (p = 0.031), hypoglycaemia (p = 0.043) and taking insulin (p < 0.001) were associated with worsened HRQoL, whereas practicing self-monitoring of blood glucose (p = 0.002) and taking aspirin (p = 0.008) had a significant association with increased HRQoL.

Conclusion: This study concluded that the HRQoL of patients was compromised in all five measuring dimensions. The EQ-5D-5L utility and EQ-VAS scores were far lower than other findings. Clinical and medication-related variables, such as a higher BMI, a higher number of medications, the presence of comorbidities and/or complications, hypoglycaemia and insulin use were associated with poor HRQoL in patients with diabetes. As a result, interventions should be individualised and focused on determinant factors.

Keywords: DIABETES & ENDOCRINOLOGY; Diabetes & endocrinology; General diabetes; General endocrinology; INTERNAL MEDICINE; Quality in health care.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Blood Glucose
  • Cross-Sectional Studies
  • Diabetes Mellitus* / epidemiology
  • Ethiopia / epidemiology
  • Health Status
  • Humans
  • Hypoglycemia* / epidemiology
  • Insulins*
  • Prospective Studies
  • Quality of Life
  • Surveys and Questionnaires


  • Blood Glucose
  • Insulins