How Do Glycated Hemoglobin Levels and Frailty Status Predict Health-related Quality of Life in Adults with Type-2 Diabetes Attending Teaching Hospitals in Nigeria?

BACKGROUND: Patients with type-2 diabetes mellitus (T2DM) often experience complications, frequent hospitalizations, and multiple treatment modalities, which adversely affect their psychosocial, physical, and environmental aspects of health-related quality of life (HRQOL) in affected persons. This low HRQOL has been associated with frailty and glycated hemoglobin (HbA1c) levels. However, inconsistent evidence about these associations has impeded the adoption of tailored care approaches for T2DM patients to address these predictors and identify vulnerable groups with poor HRQOL. PURPOSE: This study assessed HbA1c levels and frailty as predictors of HRQOL among T2DM patients. METHODS: A descriptive cross-sectional survey was done on 230 adults with T2DM ≥18 years technique attending the teaching hospitals. The participants were chosen using a systematic sampling method. Two adopted instruments, the Fried frailty phenotype and the World Health Organization Brief (WHOQOL-BREF) were used to elicit information with Cronbach’s alpha reliability coefficients ranging from 0.70 to 0.97 and biochemical measurements taken. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were employed to analyze the data. Inferential statistics of multivariate regression analysis were utilized at a significance level of 0.05. RESULTS: Adults with T2DM had a mean age and disease duration of 50.23 ± 14.43 years and 7.17 ± 5.66 years, respectively. Frailty was reported in 45.22%, with the majority (78.7%) having poor glycemic control and a mean HbA1c of 7.74 ± 1.53%. Overall, T2DM adults had a moderate HRQOL (50.37 ± 29.09), with the mean scores for the domains from highest to lowest being 52.34 ± 27.71 (psychological health), 50.29 ± 29.38 (social relationships), 49.66 ± 29.81 (environmental) and 49.19 ± 29.46 (physical health). In addition, HbA1c and frailty were found to be significant predictors of all HRQOL domains ( P < 0.001). CONCLUSION/IMPLICATIONS FOR PRACTICE: Moderate HRQOL was observed among T2DM patients and all HRQOL domains were significantly predicted by HbA1c and frailty. It is recommended that healthcare professionals, to enhance HRQOL among T2DM patients, include the frequent assessment of HRQOL and frailty in this population.