Health-Related Quality of Life in Patients with Diabetes Using the SF-20 Questionnaire in Aseer Region, Saudi Arabia

Background

Diabetes adversely affects various dimensions of life, from physical functioning to social and emotional well-being. The Aseer Region in Saudi Arabia has seen a rising prevalence of DM, necessitating assessment tools like the SF-20 to comprehensively gauge HRQoL and guide disease management^[1][2].

 

SF-20 Questionnaire

The Short Form-20 (SF-20) is a validated instrument addressing six essential domains:

·        Physical functioning

·        Role functioning

·        Social functioning

·        Mental health

·        Health perceptions

·        Bodily pain

 

This multidimensional approach makes it ideal for evaluating quality of life in chronic diseases such as diabetes^[3].

Study Design and Setting

A cross-sectional, case-control study was conducted in the Aseer Region among patients attending primary healthcare clinics. The SF-20 was administered in Arabic. Patients aged ≥18 years with diabetes were eligible; major exclusion criteria included cognitive impairment and severe comorbidities unrelated to diabetes^[1][2].

 

Data Collection

Sociodemographic (age, gender, marital status, education) and clinical data (duration of diabetes, presence of complications, comorbidities like hypertension) were recorded. Corresponding age- and sex-matched healthy controls were also surveyed for comparison^[1][2].

 

Statistical Analysis

·        Mean SF-20 scores calculated for each domain.

·        Comparisons used independent t-tests and chi-square analyses.

·        Logistic regression identified determinants of low HRQoL.

Demographics and Clinical Characteristics

·        Sample size: 110–418 patients (majority type 2 DM; both genders)^[1][2].

·        Mean age: 50–57 years.

·        More than half were married; nearly a quarter were illiterate.

·        Hypertension was the most prevalent comorbidity.

·        Peripheral neuropathy was the most common diabetes complication.

 

SF-20 Domain Scores

Diabetic patients consistently had lower SF-20 scores than controls across every domain:

 

Note: Approximate values aggregated from reported studies^[1][2][3].

 

Figure 1. SF-20 QoL Domain Scores for Diabetic Patients vs. Controls in Aseer Region

(A grouped bar chart would illustrate statistically significant lower QoL scores among diabetics across all SF-20 domains.)

 

Determinants of Low Quality of Life

·        Duration of diabetes: Longer disease duration associated with worse scores in all domains.

·        Complications: Presence of neuropathy, retinopathy, or nephropathy linked to decreased HRQoL.

·        Comorbid conditions: Particularly hypertension contributed to lower scores.

·        Socioeconomic status: Lower educational level and unemployment correlated with poorer QoL.

·        Gender: Women tended to report lower scores, especially in mental health and pain domains^[1][2][4].

 

Symptom and Emotional Impact

·        Frequent symptoms: Fatigue (42–58%), pain (37–62%), physical limitations, anxiety (35–39%).

·        Mental health: Over one-third of patients experienced anxiety or depressive symptoms.

·        Social interactions significantly affected; nearly a third had relationship difficulties^[4][5].

Comparison with Previous Literature

HRQoL in Saudi diabetics is substantially lower than in healthy controls, consistent with findings in other populations^[1][6]. Domains most affected were pain, general health perception, and mental health.

 

Clinical Implications

·        Integrated care: Diabetes management should target not only glycemic control but also pain, emotional health, and social functioning.

·        Targeted interventions: Enhanced screening for depression/anxiety and routine QoL measurement using tools like SF-20 are recommended^[2].

·        Patient empowerment and education: Programs should focus on enhancing self-management, especially among women and those with low socioeconomic status.

 

Limitations

·        Cross-sectional design limits causal inferences.

·        Self-reporting may introduce bias.

·        Data from a single-region cohort may not be generalizable to the entire country.

Diabetes negatively impacts all dimensions of quality of life in patients in the Aseer Region, as measured by the SF-20. Factors such as long disease duration, complications, and low socioeconomic status further reduce HRQoL. Multidisciplinary strategies emphasizing physical, mental, and social health are necessary to improve overall outcomes for diabetic patients in Saudi Arabia.

 

Figures

Figure 2. Distribution of HRQoL (SF-20) Scores by Domain Among Diabetic Patients in Aseer Region

(A bar graph or radar plot here would visually compare each domain’s average score.)

 

Figure 3. Prevalence of Anxiety, Depression, and Physical Symptoms in Diabetic Patients

(A stacked bar chart would highlight proportions reporting frequent symptoms and emotional problems.)

 

Tables

Table 1. Determinants of Low HRQoL in Diabetic Patients

 

Acknowledgements

This research summary is intended for academic and clinical reference. No conflicts of interest declared.

1.      Dialnet. "Health-related quality of life in patients with diabetes using sf-20 questionnaire in Aseer Region, Saudi Arabia." 2024.

2.      Alshahrani, S.M., et al. "Association between Diabetes Consequences and Quality of Life among Patients with Diabetes Mellitus in the Aseer Province of Saudi Arabia." Macedonian Journal of Medical Sciences, 2020.

3.      Alsudairy, N.M., et al. "Quality of Life and Its Determinants Among Individuals With Diabetes in Saudi Arabia: A Cross-Sectional Online Survey." Cureus, 2024.

4.      Svedbo Engström, M., et al. "New Diabetes Questionnaire to add patients’ perspectives to diabetes care for adults with type 1 and type 2 diabetes: nationwide cross-sectional study of construct validity assessing associations with generic health-related quality of life and clinical variables." BMJ Open, 2020.