Mediating effect of fasting blood glucose and peripheral arterial disease on the relationship between sexual functioning and health-related quality of life among Nigerians with type 2 diabetes.

Background: Poor glycemic control and sexual dysfunction have been shown to impair health-related quality of life (HRQoL) of individuals with diabetes. However, mediators underlying this relationship have not been evaluated. This study aimed/sought to assess the effect of fasting blood glucose (FBG) and peripheral arterial disease (PAD) on the relationship between sexual functioning (SeF) and HRQoL among Nigerians with type 2 diabetes mellitus (T2DM).

Methods: This cross-sectional study consecutively recruited 210 participants diagnosed with T2DM. The recent FBG and lipid profiles were gleaned from the medical records of the participants. We assessed the ankle-brachial index by 8 MHz handheld vascular Doppler. Participants completed the Changes in Sexual Functioning Questionnaire and Short Form 12 (SF-12) questionnaire to assess SeF and HRQoL, respectively.

Results: Significant differences exist in HRQoL of participants with good and poor glycemic control (mean rank = 111.02 vs. 93.64, p = 0.035) but none between participants with and without PAD (mean rank = 101.39 vs. 107.60, p = 0.483). There was a significant correlation between SeF and HRQoL (r = 0.181, CI = 0.043-0.313, p = 0.008), and a significant negative correlation between HRQoL and FBG (r = -0.149, CI = -0.284 - -0.008, p = 0.033). There is a significant indirect effect of impact of SeF on HRQoL through FBG (b = -0.027, t = -0.899) and PAD (b = 0.034, t = 1.246). Furthermore, the direct effect of SeF on HRQoL in the presence of the mediators was also significant (b = 0.483, p = 0.001). This shows that PAD and FBG mediates the relationship between SeF and HRQoL.

Conclusion: Good glycemic control and the absence of PAD mediate the relationship between SeF and HRQoL in Nigerians with T2DM.

Clinical trial number: Not applicable.