Abstract:
Health-related quality of life is essential in managing diabetes mellitus, as compromised
quality can negatively impact self-care and glycemic control, increasing complication risks. However, there
is limited information on Health-related quality of life in Puntland, Somalia.
Objectives: This study aimed to assess Health-related quality of life and its associated factors among adults
with type 2 diabetes attending follow-up care at public hospitals in Puntland, Somalia, from July 28 to
August 28, 2024.
Methods: a cross-sectional study involving 403 randomly selected adult type 2 diabetic patients from
public Hospitals. Data were collected through face-to-face interviews using Open Data Kit and validated
instruments, including the World Health Organization Quality of Life - Brief and Diabetes Self-Care
Activities Scale. Data were analyzed using StataMP 17, employing descriptive statistics, independent Ttests, one-way analysis of variances, and both bivariable and multivariable linear regression analyses.
Result: The mean overall health-related quality of life score was 52.9 ± 6.90, with the highest
domain score in physical health (54.9 ± 12.43) and the lowest in the environmental domain (51.38
± 16.65). The majority of participants were under 40 years old (41.19%), male (50.87%), and
resided in urban areas (79.4%). Approximately 59.31% were married.
Behaviorally, 42.18% of participants reported poor self-care practices, 48.39% exhibited low
patient empowerment.
Clinically, 83.37% had been diagnosed with type 2 diabetes mellitus for five years or less, and
27.79% reported complications, primarily depression (28.6%). Most participants (80.89%) were
on oral medications.
Multivariable analysis identified several factors significantly associated with improved health
outcomes among individuals with type 2 diabetes mellitus. Participants with secondary education
or higher demonstrated better health outcomes (β = 1.75, p = 0.040, 95% CI: 0.084, 3.42). The
absence of comorbidity was strongly correlated with better health (β = 2.62, p < 0.001, 95% CI:
1.15, 4.08). Conversely, waiting times exceeding 15 minutes negatively impacted health-related
quality of life (β = -2.32, p = 0.049, 95% CI: -4.64, -0.008).
Conclusion: The health-related quality of life among patients with type 2 diabetes mellitus in
Puntland, Somalia is moderate highlighting the significant influence of educational, clinical, and
psychosocial factors. Major barriers to improved health-related quality of life include limited
access to healthcare and diabetes-related complications.
