The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis

Research Article:

The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive

Analysis.
DR. LIBAN AHMED ADEM AND KISMOND INTERNATIONAL UNIVERSITY

Keywords: Type 2 Diabatic mellitus, Quality of Life, Physical, Emotional.

Financial support: NA

Conflicts of interest: NA

Word count: 2981 words

The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis

ABSTRACT
Purpose: This article provides a comprehensive analysis of the impact of Type 2 Diabetes Mellitus
(T2DM) on quality of life (QoL). Chronic non-communicable diseases, including T2DM, have become a
significant public health concern worldwide, and their prevalence is rising. T2DM can lead to
hyperglycemia, insulin resistance, impaired glucose tolerance, and a range of complications such as
kidney damage, retinopathy, neuropathy, and cardiovascular disorders, which all affect the QoL of
patients. The study aims to provide an extensive literature review to identify studies that report the impact
of T2DM on QoL using validated QoL instruments.

Experimental design: The authors conducted a comprehensive literature review using various databases,
including UpToDate, Medline, OVID, The Cochrane Register, Web of Science Conference Proceedings,
PubMed, scientific articles, and Google Scholar databases to identify relevant studies published between
2000 and 2023. Of the 96 studies identified, the majority were cross-sectional in nature and conducted in
Europe, North America, Asia, and Africa. The study's findings have been synthesized and presented in the
article.

Results: The article reports that T2DM can have a significant impact on physical, emotional, social, and
functional well-being, with fatigue being one of the most prevalent physical symptoms. Lack of energy
can make it difficult for patients to engage in physical activity and exercise regimens, which can result in
a sedentary lifestyle that can worsen the disease's symptoms. Additionally, T2DM can lead to anxiety and
depression, further deteriorating the QoL.

Conclusions: Understanding the severity of T2DM's impact on QoL can help healthcare professionals
develop effective treatment plans that address both physical and psychological aspects of the disease. The
article concludes that T2DM has a significant impact on the QoL of patients and highlights the need for
healthcare professionals to focus on managing T2DM effectively to improve patients' QoL.
The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis

Introduction
In developed nations, chronic non-communicable diseases account for a considerable proportion of the
disease burden, and their prevalence is rising quickly in developing nations. This is mostly caused by
population changes brought on by urbanization and demographic transition. Chronic non-communicable
diseases are generally caused by risk factors that may be avoided or changed, like lack of physical activity
and eating poorly. These factors contribute to a number of chronic disease processes that ultimately result
in an increased mortality rate. Stroke, obstructive lung disease, diabetes, and many other chronic
noncommunicable diseases are too responsible for the high mortality rate. The most important non-
communicable diseases include diabetes mellitus, cancer, chronic respiratory diseases, and cardiovascular
disease (CVD).

Diabetes mellitus is still a global problem, particularly in Africa's underdeveloped nations. If not treated
effectively, this chronic metabolic disease, which is frequently accompanied by hyperglycemia, can result
in both short-term and long-term complications. Diabetes causes life-threatening complications such as
diabetic ketoacidosis, hyperglycaemic hyperosmolar state, and macrovascular and microvascular
complications, making the disease one of the leading causes of morbidity and mortality worldwide.
Therefore, it is essential to comprehend type 2 diabetes mellitus (T2DM), a chronic metabolic disease that
affects millions of people worldwide. The prevalence of T2DM, which leads to hyperglycemia, insulin
resistance, and decreased glucose tolerance, has dramatically increased over the past few decades.
According to recent estimates, this condition affects 463 million people globally. Yet, T2DM has effects
that go beyond simply having high blood sugar. It is connected to a number of issues that can
significantly lower a person's quality of life (QoL). Those common complications include kidney damage,
retinopathy, neuropathy, and cardiovascular disorders.
Moreover, T2DM can also lead to anxiety and depression, further deteriorating the QoL. Therefore, it is
crucial to provide a comprehensive analysis of the impact of T2DM on QoL to improve patient care and
management strategies. Understanding the severity of T2DM's impact on QoL can help healthcare
professionals develop effective treatment plans that address both physical and psychological aspects of
the disease. This article aims to provide a comprehensive analysis of the impact of T2DM on QoL.

Materials and Methods

This conducted a literature review using UpToDate, Medline, OVID, The Cochrane Register, Web of
Science Conference Proceedings and Scopus databases, PubMed, scientific articles and Google Scholar
databases to identify relevant studies published between 2000 and 2023. The search terms used were
"type 2 diabetes mellitus", "quality of life", "complications", "impact", and "management". Only studies
that reported data on the impact of T2DM on QoL were included in the analysis. We focused on studies
that used validated QoL instruments and those that examined the impact of T2DM on various domains of
QoL, including physical, emotional, social, and functional well-being.
The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis
Results
For the analysis, a total of 96 studies were found and taken into consideration. Most of the studies were
cross-sectional in design and used a variety of sample sizes. The research was carried out in various parts
of the world, including Europe, North America, Asia, and Africa. The findings of the studies have been
summarized and presented below.
Millions of people throughout the world suffer with type 2 diabetes mellitus (T2DM), a chronic metabolic
disorder. This illness, which is brought on by the body's inability to manage blood sugar levels, is
characterized by high blood sugar, thirst, and polyuria as symptoms (hyperglycemia). T2DM symptoms
can have significant negative consequences on a patient's quality of life.
Fatigue is one of the most prevalent signs of T2DM. Patients frequently experience fatigue and
sluggishness as a result of their body's ineffective utilization of glucose. Patients may find it challenging
to carry out daily duties, which may have a detrimental effect on their professional and social lives.
Other typical signs of T2DM include excessive thirst and frequent urination. Patients can experience
increased toilet usage and thirst all the time. Patients may find this to be both inconvenient and
embarrassing, which may limit their ability to take part in social activities.

Impact of T2DM on Physical QoL

Physical activity is general term that includes all movement that increases energy use and is an important
part of the diabetes management plan. Exercises is a more specific form of physical activity that is
structured and designed to improve physical fitness. The excise has been shown to improve blood glucose
level, reduce cardiovascular risk factors, contribute to weight loss, and improve wellbeing.
(ElSayed et al., 2023)

Type 2 diabetes mellitus (T2DM) can have a significant impact on an individual's physical quality of life.
Many symptoms that can affect daily life and the patient's capacity for physical activity can be brought on
by the illness.
Fatigue is one of the most prevalent physical signs of T2DM. Patients with T2DM may experience a lack
of energy, making it difficult to perform physical activities and participate in exercise programs. This can
lead to a sedentary lifestyle, which can further exacerbate the symptoms of the disease.
Physical QoL is an important aspect of overall quality of life, as it directly relates to an individual's ability
to perform physical activities and the extent to which they experience symptoms related to their health.
T2DM has been found to have a significant.
A research study, which was carried out on 258 individuals diagnosed with type 2 diabetes and receiving
treatment at the outpatient clinics of the general hospital of Piraeus "Tzaneio" and Nikki's
"Ag.Panteleimon," has brought to light the adverse effects of T2D on the quality of life of patients. The
study has unequivocally demonstrated that T2D has a detrimental impact on the patients' professional life,
physical well-being, familial relationships, and sexual health. It is highly recommended that individuals
with T2D take proactive measures to manage their condition and mitigate its negative consequences. The
findings of this study are a cause for concern, but with proper care and attention, patients can lead
fulfilling lives despite their diagnosis. (Papazafiropoulou et al., 2015)
The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis
A cross-sectional study was conducted on 147 diabetes patients who were attending the University of
Nigeria Teaching Hospital, Enugu State, Nigeria. The study's findings revealed a low health status among
type 2 diabetic patients in Nigeria. The major contributors to the negative impact on health status were
old age, duration of diabetes, and the presence of other illnesses. It is recommended that healthcare
providers prioritize the management of these factors to improve the health status of diabetic
patients in Nigeria. (Adibe et al., 2018)
Similarly, In a comprehensive study of 140 patients diagnosed with type 2 diabetes mellitus, half of
whom were afflicted with diabetic retinopathy, the World Health Organization Quality of Life (WHO
QoL) assessment tool was employed to evaluate their quality of life. The findings of the study revealed
that all patients exhibited poor QoL, with those suffering from diabetic retinopathy experiencing
significantly worse scores. It is highly recommended that healthcare providers prioritize the management
of diabetic retinopathy to enhance the QoL of patients diagnosed with type 2 diabetes mellitus. This
approach is expected to yield positive outcomes and is strongly endorsed by the medical community
(Ligda et al., 2019). The WHOQOL-BREF questionnaire is another widely used measure of quality of life
that assesses physical, psychological, social, and environmental domains. The study found that T2DM
patients had significantly lower scores in domains such as physical health, mobility, and activities of daily
living (Bull et al., 2020)
These studies highlight the significant negative impact that T2DM can have on physical QoL. Patients
with T2DM may experience symptoms such as fatigue, numbness, tingling, and vision problems that can
interfere with their ability to perform physical activities and lead to a decreased physical QoL. However,
with proper management and support, patients can learn to manage their symptoms and prevent
complications, leading to an improved physical QoL. This may involve making changes to their diet and
exercise routine, taking medication as prescribed, and monitoring their blood sugar levels regularly.

Complications associated with T2DM can also negatively impact physical QoL. For example, diabetic
neuropathy, a common complication of T2DM, can lead to pain, numbness, and tingling in the feet and
hands, which can affect an individual's ability to perform physical activities. In a study conducted
by (Unmar et al., 2017) among Wuhan Union Hospital patients with T2DM, diabetic neuropathy was
found to be a significant predictor of impaired physical QoL.

Impact of T2DM on Emotional and Depression into QoL

A chronic metabolic condition known as type 2 diabetes mellitus (T2DM) affects millions of people
worldwide. In this disease, the body struggles to adequately utilize insulin, the hormone in charge of
controlling blood sugar levels. T2DM has a substantial impact on not just physical health but also on
emotional and mental well-being. Stressful aspects of having T2DM include the ongoing need to monitor
blood sugar levels. Moreover, the complications of T2DM, such as neuropathy and retinopathy, can lead
to pain and disability, making it difficult for individuals to carry out daily activities. Studies have shown
that individuals with T2DM are at a higher risk for developing depression and other emotional
disorders (Schram et al., 2009) Additionally, the stigma associated with T2DM can lead to feelings of
shame and guilt, further exacerbating emotional distress. It is crucial that people with T2DM receive
comprehensive care that addresses both their physical health and their mental and emotional wellness.
This may entail offering access to mental health services and conducting routine depression testing.
Individuals with T2DM can better manage their illness and enhance their overall quality of life by
attending to their emotional and mental health requirements.
The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis
Common mental health issues like depression and anxiety can have a serious impact on someone's
wellbeing. These disorders can significantly lower a person's quality of life when they are present along
with type 2 diabetes mellitus (T2DM). According to one study, T2DM patients with depressive symptoms
reported having a worse quality of life in terms of their physical, emotional, and social well-being
(Schram et al., 2009) . Furthermore, these symptoms can make it more difficult for people to effectively
manage their diabetes, which can result in poor glycemic control and worsen their quality of life. As a
result, it's critical to address mental health issues in T2DM patients in order to enhance their general
health and wellbeing. Figure 1 demonstrates that, as compared to people with diabetes alone,
people with depressive symptoms regularly do worse in terms of both physical and mental
health. These variations were minor to moderate in both physical and mental health. The findings
imply that the relationships between depressive symptoms and both physical and mental health
are equally strong. (Fig. 1).
In recent years, there has been a substantial increase in the significance of assessing the quality of life and
mental health of people with type 2 diabetes mellitus (T2DM), as advised (Alzahrani et al., n.d.)
Identifying patients who may be at risk of developing depression or other emotional disorders can be
made easier with the use of routine quality of life evaluations. Meanwhile, research has shown that T2DM
patients can benefit from diabetes education. According to Powers et al. in 2020, these educational
initiatives have been linked to lower healthcare expenses and more adoption of best practices by
participants. The overall implications of these findings emphasize the necessity for a thorough strategy for
controlling T2DM, including regular assessments of quality of life and diabetes education.
Emotional QoL refers to an individual's psychological well-being, including their mood, emotions, and
self-esteem. Several studies have reported that T2DM is associated with a significant negative impact on
emotional QoL. For example, a study by (Gebremariam et al., 2022) among Ethiopian patients with
T2DM found that the disease was associated with a significant impairment in the mental health domain of
the WHOQOL-BREF questionnaire. The WHOQOL-BREF questionnaire assesses physical,
psychological, social, and environmental domains of quality of life. The study discovered that T2DM
patients had considerably lower scores in areas including environment, social ties, and psychological
health.
Similarly, a study by (Al Mansour, 2020). The Diabetes Quality of Life (DQOL) questionnaire's mental
health component was significantly impaired among Saudi Arabian patients with T2DM, it was
discovered. The DQOL questionnaire measures various aspects of quality of life, including worry about
future health, impact of diabetes on daily living, and treatment satisfaction. According to the study,
T2DM patients scored significantly lower in areas like worry and social/occupational worry.
These studies highlight the significant negative impact that T2DM can have on emotional QoL. Patients
with T2DM may experience symptoms such as anxiety, depression, and decreased self-esteem that can
interfere with their emotional well-being and lead to a decreased emotional QoL. However, with proper
management and support, patients can learn to manage their symptoms and prevent complications,
leading to an improved emotional QoL. This may involve seeking support from healthcare professionals,
family, and friends, as well as participating in diabetes support groups or seeking counseling.
A considerable deterioration in emotional QoL was connected with depression, which was present in
43.5% of research participants. According to the study, people with depression scored significantly lower
than people without depression on the WHOQOL-BREF questionnaire's emotional well-being and
depression domains. Furthermore, sadness can affect a patient's physical QoL by causing symptoms
including exhaustion, decreased appetite, and a lack of willingness to exercise.
The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis
Comorbid conditions like depression bring attention to the intricate connection between the physical and
psychological well-being of T2DM patients. To enhance overall QoL, medical providers should manage
the disease holistically by addressing both physical and emotional symptoms. This may entail a
combination of medication, dietary adjustments, and mental health support services like therapy or
counseling.

Discussion
The article discusses the impact of type 2 diabetes mellitus (T2DM) on quality of life (QoL) and
emphasizes the need for a comprehensive analysis of its impact on both physical and psychological
aspects of the disease.
In this article, 96 papers from the 2000–2023 period are reviewed. These studies were located using
various databases and search terms. The study finds that T2DM affects an individual's physical,
emotional, social, and functional well-being, leading to complications such as kidney damage,
retinopathy, neuropathy, and cardiovascular disorders, as well as anxiety and depression.
Among of the typical T2DM symptoms that have an impact on a person's quality of life are fatigue,
excessive thirst, and frequent urination. The value of exercise is emphasized in the article as a way to
increase physical activity, lower cardiovascular risk factors, aid in weight loss, and enhance general
wellbeing. The study comes to the conclusion that in order to improve patient care and management
techniques, healthcare practitioners must create efficient treatment plans that target both the physical and
psychological elements of the disease.
T2DM, often known as type 2 diabetes mellitus, is a chronic condition that affects millions of people
worldwide. Both patients and medical experts are very concerned about how T2DM affects quality of life
(QoL). It is essential to do a thorough investigation of the disease's effects on both the patient's physical
and psychological demands in order to create effective treatment regimens.
T2DM significantly affects a person's physical, emotional, social, and functional well-being, according to
an analysis of 96 studies published between 2000 and 2023. A decrease in QoL may result from the
disease's consequences, including renal failure, retinopathy, neuropathy, and cardiovascular issues.
Patients with T2DM frequently develop the psychological symptoms of anxiety and depression.
Some of the typical symptoms that have an impact on someone's QoL are fatigue, excessive thirst, and
frequent urination. The article emphasizes the value of exercise in raising levels of physical activity,
lowering cardiovascular risk factors, assisting with weight loss, and boosting general wellbeing. For
optimal T2DM management, patients should follow a nutritious diet and engage in regular physical
activity.
The study comes to the conclusion that in order to improve patient care and management techniques,
healthcare practitioners must create efficient treatment plans that target both the physical and
psychological elements of the disease. Healthcare providers can assist patients in managing their
conditions and enhancing their quality of life by taking their requirements into account and providing
individualized treatment regimens.

References
 The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis
Adibe, M. O., Anosike, C., Nduka, S. O., & Isah, A. (2018). Evaluation of Health Status of Type 2 Diabetes
Outpatients Receiving Care in a Tertiary Hospital in Nigeria. PharmacoEconomics - Open, 2(3), 337–345.
https://doi.org/10.1007/s41669-017-0056-x

Al Mansour, M. A. (2020). The prevalence and risk factors of type 2 diabetes mellitus (DMT2) in a semi-urban
Saudi population. International Journal of Environmental Research and Public Health, 17(1).
https://doi.org/10.3390/ijerph17010007

Alzahrani, O., Fletcher, J. P., & Hitos, K. (n.d.). REVIEW Open Access Quality of life and mental health
measurements among patients with type 2 diabetes mellitus: a systematic review.
https://doi.org/10.1186/s12955-023-02111-3

Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., Carty, C., Chaput, J. P., Chastin,
S., Chou, R., Dempsey, P. C., Dipietro, L., Ekelund, U., Firth, J., Friedenreich, C. M., Garcia, L., Gichu, M.,
Jago, R., Katzmarzyk, P. T., … Willumsen, J. F. (2020). World Health Organization 2020 guidelines on
physical activity and sedentary behaviour. In British Journal of Sports Medicine (Vol. 54, Issue 24, pp.
1451–1462). BMJ Publishing Group. https://doi.org/10.1136/bjsports-2020-102955

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M.
E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. Lou, Prahalad, P.,
Pratley, R. E., Seley, J. J., Stanton, R. C., … on behalf of the American Diabetes Association. (2023). 5.
Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in
Diabetes-2023. Diabetes Care, 46(Supple 1), S68–S96. https://doi.org/10.2337/dc23-S005

Gebremariam, G. T., Biratu, S., Alemayehu, M., Welie, A. G., Beyene, K., Sander, B., & Gebretekle, G. B. (2022).
Health-related quality of life of patients with type 2 diabetes mellitus at a tertiary care hospital in
Ethiopia. PloS One, 17(2), e0264199. https://doi.org/10.1371/journal.pone.0264199

Ligda, G., Ploubidis, D., Foteli, S., Kontou, P. I., Nikolaou, C., & Tentolouris, N. (2019). Quality of life in subjects
with type 2 diabetes mellitus with diabetic retinopathy: A case–control study. Diabetes & Metabolic
Syndrome: Clinical Research & Reviews, 13(2), 947–952. https://doi.org/10.1016/j.dsx.2018.12.012

Papazafiropoulou, A. K., Bakomitrou, F., Trikallinou, A., Ganotopoulou, A., Verras, C., Christofilidis, G.,
Bousboulas, S., & Μelidonis, Α. (2015). Diabetes-dependent quality of life (ADDQOL) and affecting
factors in patients with diabetes mellitus type 2 in Greece. BMC Research Notes, 8(1), 786.
https://doi.org/10.1186/s13104-015-1782-8

Schram, M. T., Baan, C. A., & Pouwer, F. (2009). Depression and quality of life in patients with diabetes: a
systematic review from the European depression in diabetes (EDID) research consortium. Current
Diabetes Reviews, 5(2), 112–119. https://doi.org/10.2174/157339909788166828

Unmar, Y., Zafar, M. I., & Gao, F. (2017). Factors associated with peripheral neuropathy in type 2
diabetes: Subclinical versus confirmed neuropathy. Journal of Huazhong University of Science and
Technology. Medical Sciences = Hua Zhong Ke Ji Da Xue Xue Bao. Yi Xue Ying De Wen Ban =
Huazhong Keji Daxue Xuebao. Yixue Yingdewen Ban, 37(3), 337–342.
https://doi.org/10.1007/s11596-017-1737-5

Figures:
The Impact of Type 2 Diabetic Mellitus on Quality of Life: A Comprehensive Analysis
Figure 1.

Figure 1 ). Difference in physical and mental health between diabetic individuals with and without
depressive symptoms in studies using physical and mental components summary scores of the Short
Form. * Significant difference between diabetic individuals with and without depressive symptoms