Predictors of Quality of Life in Adults with Type 2 Diabetes in Northern Philippines

Authors

  • John Art G. Pascua Mariano Marcos State University, Ilocos Norte, Philippines
  • Jonathan M. Laranang Mariano Marcos State University, Ilocos Norte, Philippines

DOI:

https://doi.org/10.69569/jip.2026.378

Keywords:

Predictive analysis, Quality of life, Self-care management ability, Self efficacy, Type 2 diabetes mellitus

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition that can substantially affect quality of life (QoL) across physical, psychological, social, and environmental domains. Although self-care management and self-efficacy are recognized as important factors in diabetes outcomes, their contributions to QoL remain insufficiently examined in community-based populations. This study examined the predictive contributions of self-care management ability and self-efficacy to QoL among adults with T2DM in Laoag City, Ilocos Norte, Philippines. A cross-sectional predictive correlational design was employed among 150 adults with T2DM selected through total enumeration. Data were collected using the Diabetes Self-Management Questionnaire (DSMQ), Diabetes Empowerment Scale (DES), and WHOQOL-BREF. Descriptive statistics and MM-estimator robust multiple regression with 1,000-resample bootstrapped confidence intervals were used following assessment of regression assumptions. Results showed significant regression models for physical health (Robust R² = 0.255, p < 0.001), psychological health (Robust R² = 0.114, p = 0.009), and social relationships (Robust R² = 0.194, p < 0.001). Dietary control (β = 0.232, p = 0.026) and glucose management (β = 0.257, p = 0.021) significantly predicted physical health. For psychological health, glucose management was a significant predictor (β = 0.254, p = 0.040), whereas dietary control was not significant (β = 0.219, p = 0.058). For social relationships, dietary control (β = 0.225, p = 0.030) and glucose management (β = 0.292, p = 0.009) were significant positive predictors. The environmental model was not significant (Robust R² = 0.105, p = 0.063). Findings indicate that specific self-care behaviors, particularly glucose management and dietary control, contribute to selected QoL domains, with physical health showing the greatest explained variance. Structural, socioeconomic, and contextual factors beyond individual self-care behaviors may more strongly influence environmental QoL.

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References

Adarmouch, L., Sebbani, M., Dahmash, L., & Amine, M. (2020). Self-care activities among patients with type 2 diabetes in Morocco: Prevalence and determinants. Open Journal of Epidemiology, 10(1), 79–90. https://doi.org/10.4236/ojepi.2020.101005

Amado, C., Bianco, A., Boente, G., & Rodrigues, I. (2023). Robust estimation of heteroscedastic regression models: A brief overview and new proposals. arXiv. https://doi.org/10.48550/arXiv.2311.02822

American Diabetes Association Professional Practice Committee. (2025). Introduction and methodology: Standards of care in diabetes-2025. Diabetes Care, 48( Suppl 1):S1-S5. https://doi.org/10.2337/dc25-SINT

Anderson, R., Fitzgerald, J., Gruppen, L., Funnell, M., & Oh, M. (2003). The Diabetes Empowerment Scale-Short Form (DES-SF). https://doi.org/10.2337/diacare.26.5.1641-a

Baumeister, S.E., Kocher, T., Papapanou, P., Holtfreter, B., & Demmer, R. (2026). Cross‐sectional studies: Strengths, limitations, and methodological considerations. Journal of Periodontal Research. https://doi.org/10.1111/jre.70063

Davies, M., Aroda, V., Collins, B. et al. (2022). Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia, 65, 1925–1966. https://doi.org/10.1007/s00125-022-05787-2

de Lucena, J.M.S., Vancea, D.M.M., de Brito-Gomes, J.L., Clael, S., de Araújo Ribeiro, A.L., Porto, L.G.G., & Martins, W.R. (2026). Living with diabetes: Quality of life and functional impairment among adults with type 2 diabetes in Northern Brazil. Scientific Reports. https://doi.org/10.1038/s41598-026-37453-7

Eshtaya, R., Ayed, A., Malak, M., & Shehadeh, A. (2025). The association between diabetes management self-efficacy and quality of life among Palestinian patients with type 2 diabetes. BMC Primary Care, 26(1), 274. https://doi.org/10.1186/s12875-025-02980-1

Habibi Soola, A., Davari, M., & Rezakhani Moghaddam, H. (2022). Determining the predictors of self-management behaviors in patients with type 2 diabetes: An application of socio-ecological approach. Frontiers in Public Health, 10, 820238. https://doi.org/10.3389/fpubh.2022.820238

Harb, F.S., Algunmeeyn, A., Othman Abu Hasheesh, M., El-Dahiyat, F., Alomar, I., Elrefae, A., & Shnikat, R.A. (2025). Early predictors of quality of life among patients with type 2 diabetes mellitus in southern Jordan. SAGE Open Nursing, 11, 23779608251323813. https://doi.org/10.1177/23779608251323813

Hurst, C., Rakkapao, N., & Hay, K. (2020). Impact of diabetes self-management, diabetes management self-efficacy and diabetes knowledge on glycemic control in people with type 2 diabetes (T2D): A multi-center study in Thailand. PLOS ONE, 15(12), e0244692. https://doi.org/10.1371/journal.pone.0244692

International Diabetes Federation. (2024). IDF diabetes atlas (11th ed.). https://diabetesatlas.org

Khalooei, A., & Hasheminejad, Z. (2023). Association of diabetes management self-efficacy with adherence to medication, glycemic control, and disease outcomes among type 2 diabetes patients. Shiraz E-Medical Journal, 24(24), e138227. https://doi.org/10.5812/semj-138227

Khunkaew, S., Fernandez, R., & Sim, J. (2019). Demographic and clinical predictors of health-related quality of life among people with type 2 diabetes mellitus living in northern Thailand: A cross-sectional study. Health and Quality of Life Outcomes, 17(1), 177. https://doi.org/10.1186/s12955-019-1246-2

Maronna, R., Martin, R.D., Yohai, V., & Salibián-Barrera, M. (2019). Robust statistics: Theory and methods (with R). John Wiley & Sons. https://shorturl.at/mdTam

Mendoza-Núñez, V.M., Flores-Bello, C., Correa-Muñoz, E., Retana-Ugalde, R., & Ruiz-Ramos, M. (2016). Relationship between social support networks and diabetes control and its impact on the quality of life in older community-dwelling Mexicans. Nutricion Hospitalaria, 33(6), 1312–1316. http://dx.doi.org/10.20960/nh.776

Oluma, A., Abadiga, M., Mosisa, G., Fekadu, G., & Turi, E. (2020). Perceived self-efficacy and associated factors among adult patients with type 2 diabetes mellitus at public hospitals of Western Ethiopia, 2020. Patient Preference and Adherence, 1689–1698. https://doi.org/10.2147/PPA.S275887

Orozco-Beltrán, D., Mata-Cases, M., Artola, S., Conthe, P., Mediavilla, J., & Miranda, C. (2016). Abordaje de la adherencia en diabetes mellitus tipo 2: Situación actual y propuesta de posibles soluciones [Adherence of type 2 diabetes mellitus approach: Current situation and possible solutions]. Atención Primaria, 48(6), 406–420. https://doi.org/10.1016/j.aprim.2015.09.001

Peng, X., Guo, X., Li, H., Wang, D., Liu, C., & Du, Y. (2022). A qualitative exploration of self-management behaviors and influencing factors in patients with type 2 diabetes. Frontiers in Endocrinology, 13, 771293. https://doi.org/10.3389/fendo.2022.771293

Philippine Statistics Authority. (2025, January 31). Leading causes of death in the Philippines for 2024: Ischaemic heart diseases, neoplasms, and cerebrovascular diseases (Reference No. 2025-34). https://psa.gov.ph/statistics/vital-statistics/node/1684066660

Schmitt, A., Kulzer, B., Ehrmann, D., Haak, T., & Hermanns, N. (2022). A self-report measure of diabetes self-management for type 1 and type 2 diabetes: The Diabetes Self-Management Questionnaire-Revised (DSMQ-R) – Clinimetric evidence from five studies. Frontiers in Clinical Diabetes and Healthcare, 2:823046. https://doi.org/10.3389/fcdhc.2021.823046

Schmitt, A., Reimer, A., Hermanns, N., Huber, J., Ehrmann, D., Schall, S., & Kulzer, B. (2016). Assessing diabetes self-management with the diabetes self-management questionnaire (DSMQ) can help analyse behavioural problems related to reduced glycaemic control. PloS one, 11(3), e0150774. https://doi.org/10.1371/journal.pone.0150774

Tamornpark, R., Utsaha, S., Apidechkul, T., Panklang, D., Yeemard, F., & Srichan, P. (2022). Quality of life and factors associated with a good quality of life among diabetes mellitus patients in northern Thailand. Health and Quality of Life Outcomes, 20(1), 81. https://doi.org/10.1186/s12955-022-01986-y

Wan, E., Fung, C., Choi, E., Wong, C., Chan, A., Chan, K., & Lam, C. (2016). Main predictors in health-related quality of life in Chinese patients with type 2 diabetes mellitus. Quality of Life Research, 25(11), 2957–2965. https://doi.org/10.1007/s11136-016-1324-4

WHOQOL Group. (1995). The World Health Organization Quality of Life assessment (WHOQOL): Position paper from the WHO. Social Science & Medicine, 41(10), 1403–1409. https://doi.org/10.1016/0277-9536(95)00112-K

WHOQOL Group. (1998). Development of the WHOQOL instrument. Social Science & Medicine, 46(12), 1569–1585. https://doi.org/10.1016/S0277-9536(98)00009-4

Yousaf, M.F., Aslam, A., Aslam, Z., & Mukhtar, F. (2023). Assessment of quality of life of patients with type-II diabetes mellitus. Annals of Punjab Medical College, 17(2), 168–173. https://apmcfmu.com/index.php/apmc/article/view/1388

Zhou, B., Rayner, A., Gregg, E., et al. (2024). Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: A pooled analysis of 1108 population-representative studies with 141 million participants. The Lancet, 404, 2077–2093. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02317-1/fulltext

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Published

2026-09-04

How to Cite

Pascua, J. A., & Laranang, J. (2026). Predictors of Quality of Life in Adults with Type 2 Diabetes in Northern Philippines. Journal of Interdisciplinary Perspectives, 4(10), 137–146. https://doi.org/10.69569/jip.2026.378