ArticleActa diabetologica2026
Health-related quality of life in adults with type 2 diabetes mellitus: the role of multi morbidity, glycaemic control and insulin therapy in an Albanian outpatient cohort.
Article in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsTo describe health-related quality of life (HRQoL) across the eight SF-36 domains in Albanian adults with type 2 diabetes mellitus (T2DM), identify demographic and clinical correlates of HRQoL, and assess whether associations with multimorbidity were robust to an alternative principal component analysis (PCA)-derived weighted multimorbidity index.
methodsIn this cross-sectional study, 176 adults with T2DM completed the SF-36 questionnaire. Sociodemographic characteristics, diabetes duration, HbA1c, insulin therapy and physician-confirmed comorbidities were recorded. Multivariable linear regression models with robust standard errors examined adjusted associations between clinical characteristics and SF-36 domains. To address limitations of an unweighted comorbidity count, a PCA-derived weighted multimorbidity index was constructed and used in sensitivity analyses. Interaction analyses were considered exploratory.
resultsParticipants had a mean age of 65.1 years, mean diabetes duration of 10.8 years, and mean HbA1c of 7.74%; 54.0% were receiving insulin therapy and 43.8% had multimorbidity. General Health, Role-Physical and Vitality were the most impaired SF-36 domains. In adjusted analyses, multimorbidity was independently associated with lower Physical Functioning, Vitality, Mental Health, Social Functioning, Bodily Pain and General Health scores. Older age was also associated with poorer HRQoL across several domains. After adjustment, neither insulin therapy nor HbA1c was independently associated with most physical HRQoL domains. Findings were materially unchanged when multimorbidity was operationalised using the PCA-derived weighted index.
conclusionsIn this Albanian outpatient cohort, multimorbidity was the strongest independent cross-sectional correlate of impaired HRQoL across both physical and psychosocial domains. The association remained robust to alternative operationalisations of comorbidity burden. Given the cross-sectional design, modest sample size and potential residual confounding, findings should be interpreted as hypothesis-generating and warrant confirmation in larger longitudinal studies.
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