Diabetes mellitus is a long term progressive non-transmittable disease that ensues when the rnpancreas either cannot excrete sufficient insulin or when the human cells are insensitive to the rninsulin produced by the pancreas. Over the years diabetes has been associated with lifestyle rnmodifications like physical inactivity unhealthy diet and obesity which can lead to rncomplications associated with cardiovascular risks and renal disorders. This in turn reduces rnthe quality of life and life expectancy in people with diabetes 39.rn Over 280 million people have diabetes mellitus globally with this statistic expected to increase rnto about 400 million by the year 2030 with the biggest population being in the developing rncountries. In every 5 people living with diabetes in developing countries 4 of them are men rnand women who are breadwinners of their families 28.rn The effects of Diabetes go beyond the individual as they also affect families societies national rnproductivity and have socio-economic effects which in the developing countries co-exist with rnother diseases like cardiovascular diseases 39.rn The National Diabetes strategy 2015-2020 in Kenya indicates that the occurrence of diabetes rnin the adult population is 4.56 750000 persons and 20000 deaths annually. Moreover this rnis likely not to be the true picture as 60 of individuals diagnosed with diabetes in Kenya go rnto health facilities with unconnected complaints 23.rn The social bodily and emotional facets of health of an individual that are affected by the rnpersons values hopes and experiences are highlighted by the measure of their quality of life. rnIt is then of significance for health care workers to recognize the bodily social and emotional rndomains impacted by a chronic illness such as diabetes 16. Furthermore the negative impact rnit has on the social domain life expectancy and academic performance ultimately affects their rnquality of life which is decreased by micro-vascular plus macro-vascular complications 16.rn Assessment of ones well-being in the context of health is increasingly becoming a significant rnend result measure of treatment and health interventions in patients with long-term illnesses rn11.rn Current care of diabetic patients focuses on treatment and how drugs can prolong their life span rnleaving out on the impact diabetes has socially emotionally and financially
Assessment of ones well-being in the context of health is increasingly becoming a significant rnend result measure of treatment and health interventions in patients with long-term illnesses rn11.rn Current care of diabetic patients focuses on treatment and how drugs can prolong their life span rnleaving out on the impact diabetes has socially emotionally and financially
A cross-sectional descriptive research design was used to describe what is happening at the rncurrent moment or specific point in time. This design was adopted as it sought to highlight rndifferences between or association among the variety of study subjects diabetic patients. The rnindependent variables included socio-demographic and health-related characteristics patient rncharacteristics which the researcher sought to find out how they were associated with either rnlow/ high health related quality of life dependent variable in type 2 diabetes mellitus patients.
The research findings rnindicated that foot problem and numbness in hands/ legs/feet were the health-related rncharacteristics related to low HRQOL among type two diabetes mellitus patients. Study rnparticipants who had foot problem were seven times more likely to have low health-related rnquality of life compared to those who did not have the comorbidity. In addition study rnparticipants who had numbness/pain in hands/legs/feet were more likely to have low healthrnrelated quality of life compared to those who did not have the co-morbidity. These study rnfindings are similar to a study done in Brazil by 22 that showed that 34 17rn of the elderly diabetic participants who had foot wounds had lower quality of life due to rndecreased autonomy and social participation as a result of decreased mobility associated with rnneuropathic/vascular pain. Similar study findings were found in Saudi Arabia 3 which rnshowed that despite the overall health related quality of life being moderate 69 of the study rnparticipants who had pain/discomfort had severe to extreme health state that translated to low rnhealth-related quality of life 3. On the influence of type two diabetes mellitus on the healthrnrelated quality the research findings indicated a considerable perceived negative impact of rndiabetes mellitus type 2 on the HRQOL of the 165 patients. Over half of the study participants rnperceived that their health-related quality of life would be better without/ in the absence of typern two diabetes mellitus. This research finding is similar to a Bulgarian study which showed that rn275 67.1 of the respondents perceived that their quality of life would be better without rnT2DM since the diabetes specific QoL mean score was at -1.8 5.rn The ADDQoL scoring ignores non-applicable domains and gives greater emphasis to domains rnof greater importance to the individual. Among the 19 domain specific items the study rnparticipants rated sex life as the most negatively impacted/ important as compared to other rnitems. This is despite also all other items being negatively influenced by T2DM. This wasrn further coupled with negative influence of T2DM on the health-related quality of life which rnwas indicated with a negative mean score of the AWI of the 165 study participants. rnThis research finding is in contrast to most other studies using the ADDQoL where the itemrn reflecting the greatest negative influence of diabetes on the health-related quality of life wasrn Freedom to eat as I wish. A study 10 indicated that freedom to eat as I wish was the most rnnegatively impacted at WI -3.35. Also a study done in Bulgaria showed that freedom to rneat as I wish was the most negatively impacted at WI -4.0 followed by Family life WI -3.9. In addition the mean AWI score for the population was -2.9 which indicated an overall rnnegative impact of T2DM on quality of life 5
A total of 199 participants filled the research tool out of which 165 participants were identified rnas the required sample size. Most of the participants were female at 116 70 married were rn127 77 and 114 69 had no source of income. Those living with diabetes for a duration rnof between 6 months-10 years were 113 69 most common treatment regimen was oral rnmedication at 145 88 and co-morbidities like high blood pressure 113 69 eye/ vision rnproblems 76 46 numbness or pain in feet/ legs 118 72 were the most common among rnthe participants.
Over half of the study participants 127 77 indicated that their health-related quality of lifern would be better in the absence of diabetes mellitus 5. The overall mean ADDQoL AWIrn score 4.48 indicated that the health-related quality of life was negatively impaired by typern two diabetes mellitus. Since over half of the study participants perceived a low health-relatedrn quality of life then it can be concluded that most were aware of the influence of T2DM onrn their health status and ultimately on their health-related quality of life 3.rn Co-morbidities of foot problem and numbness/pain in hands/ legs/feet were associated with rnlow health-related quality of life. This may be due to the fact that diabetes neuropathy and rnneuropathic pain is one of the many complications associated with diabetes mellitus 22.rn Sexual satisfaction/ sexual function was an item which was the most negatively impacted and rnmost important domain of the patients quality of life while self-dependence was the leastrn negatively impacted domain. This may be due to the fact that microvascular complications likern sexual dysfunction infertility/ impotence is associated with diabetes mellitus