Diabetes Quality of Life among Elderly Diabetic Patients and Its Associations

INTRODUCTION

Elderly diabetic patients are increasing in number worldwide due to improvement in healthcare services provided by most countries. In fact, Malaysia is evolving towards geriatric population predominant country in 2030 in which a lot of health aspects surrounding geriatrics need to be taken care of from now.  Diabetes comes with morbidities and complications in which quality of life of geriatric patients should be measured and the associated factors should be determined.

METHODS

A cross sectional study was conducted among 269 elderly diabetic patients from all government health clinics within district of Kuantan. Their sociodemographic data were recorded and level of quality of life was measured using validated Diabetes Quality of Life Instrument (DQoL). Non-parametric tests namely Mann Whitney U test and Kruskal Wallis tests were used to identify the association between domains of quality of life and variables. The predictors were identified via logistic regression analysis.

RESULTS & DISCUSSION

Majority of patients were female (61%), had at least primary level of education (52%) with financial income falls within B40 groups (97.4%). Majority of the clinic were located in rural area (61.3%), without presence of Family Medicine Specialist (77.7%), mostly managed by medical officers and diabetic educators only (55.8%) without any tertiary care (72.5%). Surprisingly, majority of patients had uncontrolled diabetes (71.7%), uncontrolled blood pressure readings (63.2%), uncontrolled lipid levels (74.2%) and abnormal abdominal circumferences (84.8%). Clinic location, diabetes control status and the geriatric age were statistically significant for predicting patients’ diabetes quality of life.

CONCLUSION

This study proved that geriatric patients had better quality of life by lowering further the HbA1c target despite misconception of high likelihood of complications among elderly. Social support and financial status of patients determined the level of quality of life in elderly that should be incorporated as parameters that should be enquire during each geriatric visits. Rather than looking at patient and environmental factors only, this study also revealed that each clinic had their own unique management strategy. Those that lead by family medicine specialist and other major supporting staff which usually present in central city provided the best level of quality of life towards patients. Therefore, more primary care physician and local management strategy should be produced.