Fatores relacionados à capacidade funcional e controle glicêmico como preditores da Qualidade de Vida Relacionada à Saúde em indivíduos com diabetes Tipo 2 numa cidade do Norte do Brasil

Abstract

Introduction: Type 2 diabetes mellitus (DM2) affects health, social relationships, physical fitness and functionality and quality of life. The aim of this study was to verify whether variables related to functional capacity and glycemic control are predictors of health-related quality of life (HRQOL) of DM2 patients in the city of Tocantinopolis (TO). Methods: This is a cross-sectional and predictive study. The sample was required for convenience. The sample included people with DM2, male and female, over 40 years of age, which corresponded to 16% of the population of people with DM2 and hypertension treated by the SUS in the city of Tocantinopolis, Tocantins, Brazil. All answered a questionnaire containing sociodemographic information, diabetes characteristics (time since diagnosis and chronic complications), physical activity, smoking and/or alcohol use, sleep quality and health and a HRQL questionnaire specific for DM2 (DQOL). Additionally, tests related to functional capacity (handgrip with a dynamometer, sitting and standing, walking for six minutes), mobility (Timed up and go Test (TUG)) and glycemic control (glycated hemoglobin - HbA1c) were performed. To assess whether variables related to functional capacity and glycemic control predict HRQoL, multiple linear regression was used. Analyzes were performed using the statistical program R v. 3.6.3; for all analyses, the significance level for adjusting the variables in the model at 20% was adopted. Results: the sample of respondents to the questionnaire was 100 people with DM2, a subsample of 32 people performed all the tests provided that were motivated by multiple linear regression. Not having DM2 complications (β = 7.9; p = 0.197) and having more strength in the upper (β = 2.5; p = 0.074) and lower limbs (β = 0.360; p = 0.2) were associated with Domain Satisfaction with DM2 treatment. Lower limb strength (β = 2,104; p = 0.094) was associated with a decrease in perceived impact on HRQOL. Flexibility also associated with the domain of Social / Vocational Concerns. Having more lower limb strength (β = 1,932; p = 0.067) and flexibility (β = 0.318; p = 0.142) was associated with better overall HRQoL. HbA1c was inversely associated with general HRQOL (β = -1.307; p = 0.198), higher perception of the Impact of the disease (β = -2.109; p = 0.070) and worse perception of Social / vocational concerns (β = -0.955 ; p = 0.138). Conclusion: the predictive model with the variables not having complications, strength of upper and lower limbs predicted 12% satisfaction with the treatment in people with DM2. Glycated hemoglobin and lower limb strength predict 14% of the perceived impact of DM2. The social/vocational concerns domain had a lower predictive power (0.125%) influenced by the variables flexibility and glycated hemoglobin. Finally, 12.5% of overall HRQOL is predicted by lower limb strength, flexibility and glycated hemoglobin.