Quality of Life Research

, Volume 28, Issue 2, pp 481–490 | Cite as

Determinants for quality of life trajectory patterns in patients with type 2 diabetes

  • Ruey-Hsia WangEmail author
  • Kuan-Chia Lin
  • Hui-Chun Hsu
  • Yau-Jiunn Lee
  • Shyi-Jang Shin



The purpose of the study was to identify quality of life (QoL) trajectory patterns and the determinants in patients with Type 2 diabetes (T2DM).


A longitudinal design was employed. Totally, 466 patients with T2DM recruited from five diabetic clinics in Taiwan were participants of this study. Demographic and disease characteristics, biomedical factors (HbA1c levels and body mass index), psychosocial factors (self-care behaviors, social support, resilience, diabetes distress), and QoL were collected at baseline. QoL was further measured every 6 months for four waves after baseline. Latent class growth analysis was used to identify QoL trajectory patterns. The multinomial logistic regression was further applied to explore the important determinants of different QoL trajectory patterns.


The “steadily poor” (n = 27, 5.8%), “consistently moderate” (n = 174, 37.3%), and “consistently good” (n = 265, 56.9%) trajectory patterns were identified. The HbA1c levels (OR 2.16) and diabetes distress (OR 1.18) were important for determining participants in the “steadily poor” QoL trajectory pattern. HbA1c levels (OR 1.25) and diabetes distress (OR 1.14) were important for determining participants in the “consistently moderate” QoL trajectory pattern.


To prevent development of relatively worse QoL trajectory patterns in patients with T2DM in a timelier manner, healthcare providers could regularly assess the QoL and provide intervention, especially for those with high HbA1c levels and high diabetes distress. Meanwhile, early intervention for decreasing HbA1c levels and diabetes distress may improve the trajectory development of QoL in patients with T2DM.


Type 2 diabetes Quality of life Trajectory pattern Self-care behaviors Diabetes distress Glycemic control 



The authors would like to thank Yu-Hsuan Huang for helping in data analysis.


The funding of this study was supported by the National Science Council, Taiwan (NSC-102-2628-B-037-012-MY3).

Compliance with ethical standards

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

The studies have been approved by the appropriate institutional and/or national research ethics committee (approval number: KMUH-IRB-20120347). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Ruey-Hsia Wang
    • 1
    • 2
    Email author
  • Kuan-Chia Lin
    • 3
    • 4
  • Hui-Chun Hsu
    • 5
  • Yau-Jiunn Lee
    • 5
  • Shyi-Jang Shin
    • 6
  1. 1.College of NursingKaohsiung Medical UniversityKaohsiung CityTaiwan, ROC
  2. 2.Department of Medical ResearchKaohsiung Medical University HospitalKaohsiung CityTaiwan, ROC
  3. 3.Institute of Hospital and Health Care AdministrationNational Yang-Ming UniversityTaipei CityTaiwan, ROC
  4. 4.Preventive Medicine Research CenterNational Yang-Ming UniversityTaipei CityTaiwan, ROC
  5. 5.Lee’s Endocrinology ClinicPingtung CityTaiwan, ROC
  6. 6.Division of Endocrinology and Metabolism, Department of Internal MedicineKaohsiung Medical University HospitalKaohsiung CityTaiwan, ROC

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