High insulin injection frequency is a key independent predictor of health-related quality-of-life in diabetic patients in Algeria

Vollständiger Abstract

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Background: Diabetes is widely studied in Algeria, but its associated health-related quality-of-life remains underexplored. Aim: To assess health-related quality-of-life and predictors of reduced health-related quality-of-life among Algerian patients with type 1 or type 2 diabetes mellitus receiving insulin therapy. Methods: From July 2019 to February 2020, we interviewed 400 confirmed diabetes patients who had been receiving insulin treatment for ≥6 months at the Internal Medicine Department of Tlemcen University Hospital and outpatient clinics in Agadir and Boudghen. We analysed the data using SPSS version 25 and used independent t test or one-way analysis of variance to analyse differences in EuroQol 5-Dimension 5-Level index values and EuroQol visual analogue scale scores across subgroups. We used χ2 test to compare the differences in reported problems across EuroQol 5-Dimension 5-Level dimensions among the subgroups. P < 0.05 was considered statistically significant. Results: The mean EuroQol 5-Dimension 5-Level index value was 0.595 ± 0.23, and mean EuroQol visual analogue scale score was 60.51 ± 20.45. Multiple linear regression associated ≥4 insulin injections per day with reduced healthrelated quality-of-life, and this relationship was strong and persistent even after controlling for clinical factors such as haemoglobin A1c levels. It affected mostly the psychological dimensions. Conclusion: Our finding shows moderate health-related quality-of-life and a significant psychological burden among insulin-treated patients. It identifies high insulin injection frequency as a key predictor of reduced health-related qualityof-life, independent of glycaemic control. We recommend multidimensional measures, based on mental health support and education, to mitigate treatment burden beyond traditional diabetes management.