Health-related quality of life in South Asian adults with type 2 diabetes - a systematic review and meta-analysis

This systematic review and meta-analysis synthesized evidence on health-related quality of life (HRQoL), estimated using the EuroQol EQ-5D instrument, among individuals with type 2 diabetes mellitus (T2DM) and its complications in South Asian countries. We conducted a systematic search of PubMed-Medline, Scopus, Embase, Cochrane Controlled Register of Trials (CENTRAL) and Google scholar for studies reporting EQ-5D utility and VAS scores among individual with type 2 diabetes mellitus (T2DM) in South Asian countries. Eligible studies underwent a comprehensive systematic review and quality assessment using established appraisal tools. Mean EQ-5D scores were pooled in meta-analysis employing a random-effects DerSimonian–Laird model, and subgroup analyses were performed to explore sources of heterogeneity among the included studies. Meta-Regression analysis was conducted to evaluate the associations of age and disease duration with EQ-5D utility scores. The reviews protocol was registered in PROSPERO to ensure methodological transparency and reduce the risk of bias. A total of 22 studies conducted in individual with T2DM from South Asia were included. The pooled mean EQ-5D utility score was 0.75 (95% CI: 0.65–0.85) and mean Eq. 5D VAS score was 65.17 (95% CI: 57.81–72.54), indicating moderate HRQoL. individuals with T2DM complications had significantly lower scores utility score of 0.58 than compared to 0.81 among those without complications. Pain/discomfort and anxiety/depression were the most frequently reported domain with problems (58% and 53% respectively). Subgroup analyses revealed lower HRQoL for females, those with longer diabetes duration, with no comorbidities and in certain countries. Pooled utility values for T2DM individuals provide valuable insights into their HRQoL and are essential for informing health economics research. The observed associations between age, disease duration, and utility scores underscore the dynamic challenges of HRQoL over time, emphasizing the importance of tailored, long-term management strategies for diabetes care.