Authors
Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
Abstract
CONTEXT: Quality of life (QOL) is one of the important indexes of health and well‑being promotion
in the diabetic patients. Based on numerous studies, these patients have a lower QOL, compared
to nondiabetic individuals. In addition, a higher prevalence of sexual function disorder has been
reported in their population that can have a negative effect on their QOL.
AIMS: This study aimed to investigate the association between sexual function and QOL in diabetic
women referring to health care centers in Mashhad during 2013–2014.
SETTINGS AND DESIGNS: In this correlational study, the association between sexual function and
QOL in 90 diabetic women with type two diabetes referring to health care centers in Mashhad during
2013–2014 was investigated.
SUBJECTS AND METHODS: Data were collected by Rosen female sexual function index and short
form‑36 questionnaires.
STATISTICAL ANALYSIS USED: Data were analyzed by mean comparison and Spearman
correlation coefficient statistical test through SPSS 16.
RESULTS: Subjects’ mean sexual function score was 21.7 ± 6.30. Based on the finding, 25.6% of the
subjects suffered from sexual function disorder. Subjects’ mean score of QOL was 58.75 ± 1616.24.
There was a significant association between an overall score of sexual function and its subscales,
with their QOL and two dimensions of overall physical and psychological and mental health scores
(P < 0.005).
CONCLUSIONS: Sexual function is one of the important and associated aspects of QOL in diabetic
patients. Designing and evaluation of the interventions with the goal of an improvement in this variable
plays a notable role in the promotion of these patients’ QOL. However, with regard to limited research
in this field, further studies on this association are suggested.
Keywords
1. Rummans TA, Clark MM, Sloan JA, Frost MH, Bostwick JM,
Atherton PJ, et al. Impacting quality of life for patients with
advanced cancer with a structured multidisciplinary intervention:
A randomized controlled trial. J Clin Oncol 2006;24:635‑42.
2. Darvishpoor KakhkiA, Abed SaeediZ, Yaghmaie F, Alavi Majd H,
Montazeri A. Survey correlation between quality of life and
disease and demographic variables of diabetic patients referred
to Tehran hospitals in 2004. Iran J Endocrinol Metab 2006;8:49‑56.
3. Darban F. The Effect of Stress Inoculation Program on the Quality
of Life of Nurses Working in Psychiatric Wards: Mashhad
University Of Medical Science; 2012.
4. Sadabadi MH, Babapour Kheirodin J. Comparison of quality of
life and coping strategies in diabetic and nondiabetic people.
J Shahid Sadoughi Univ Med Sci 2012;20:581‑92.
5. Ahmadi A, Zade JH, Madise MR, Lashkari L. Effective factors
in the quality of life in patients with type 2 diabetes. J North
Khorasan Univ Med Sci 2011;3:7‑13.
6. Lam CL, Lauder IJ. The impact of chronic diseases on the
health‑related quality of life (HRQOL) of Chinese patients in
primary care. Fam Pract 2000;17:159‑66.
7. Soltan Ahmadi ZH, Ranjbar H, Kohan M. The relationship
between sexual function of diabetic women with quality of life.
J Shahid Beheshti Univ Med Sci 2013;23:32‑9.
8. Hisasue S, Kumamoto Y, Sato Y, Masumori N, Horita H, Kato R,
et al. Prevalence of female sexual dysfunction symptoms and its
relationship to quality of life: A Japanese female cohort study.
Urology 2005;65:143‑8.
9. Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual
dysfunction: Current perspectives. Diabetes Metab Syndr Obes
2014;7:95‑105.
10. Ramezani M, Dolatian M, Shams J, Alavi H. The relationship
between self‑esteem and sexual dysfunction and satisfaction in
women. Arak Med Univ J 2012;14:57‑65.
11. Zeighami Mohammadi SH, Ghaffar F. Sexual dysfunction and
its correlation with quality of life among women affected with
cancer. Iran J Obstet Gynecol Infertil 2009;12:39‑46.
12. Veronelli A, Mauri C, Zecchini B, Peca MG, Turri O, Valitutti MT,
et al. Sexual dysfunction is frequent in premenopausal women
with diabetes, obesity, and hypothyroidism, and correlates with
markers of increased cardiovascular risk. A preliminary report.
J Sex Med 2009;6:1561‑8.
13. Lowenstein L, Pierce K, Pauls R. Urogynecology and sexual
function research. How are we doing? J Sex Med 2009;6:199‑204.
14. Raina R, Pahlajani G, Khan S, Gupta S, Agarwal A, Zippe CD.
Female sexual dysfunction: Classification, pathophysiology, and
management. Fertil Steril 2007;88:1273‑84.
15. Kiadaliri AA, Najafi B, Mirmalek‑Sani M. Quality of life in people
with diabetes: A systematic review of studies in Iran. J Diabetes
Metab Disord 2013;12:54.
16. Diabetes Atlas 2012: 371 Million Cases Worldwide; 2015 Available
from: HYPERLINK “http://www.jnj.com/sites/default/files/
pdf/Facts‑About‑Diabetes‑Infographic.pdf” http://www.jnj.
com/sites/default/files/pdf/Facts‑About‑Diabetes‑Infographic.
pdf. [Last updated on 2015 May 12; Last cited on 2015 May 14].
17. Shaw JE, SicreeRA, Zimmet PZ. Global estimates of the prevalence
of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87:4‑14.
18. Siddiqu MA, Ahmed Z, Ahmed‑Khan A. Psychological impact
on sexual health among diabetic patients: A review. Int J Diabetes
Res 2012;1:28‑31.
19. Shi YF, Shao XY, Lou QQ, Chen YJ, Zhou HJ, Zou JY. Study on
female sexual dysfunction in type 2 diabetic Chinese women.
Biomed Environ Sci 2012;25:557‑61.
20. Enzlin P, Rosen R, Wiegel M, Brown J, Wessells H, Gatcomb P,
et al. Sexual dysfunction in women with type 1 diabetes:
Long‑term findings from the DCCT/EDIC study cohort. Diabetes
Care 2009;32:780‑5.
21. Pontiroli AE, Cortelazzi D, Morabito A. Female sexual dysfunction
and diabetes: A systematic review and meta‑analysis. J Sex Med
2013;10:1044‑51.
22. Walsh KE, Berman JR. Sexual dysfunction in the older woman:
An overview of the current understanding and management.
Drugs Aging 2004;21:655‑75.
23. Noosh‑Abadi AN, Rezaei O, Ebrahimi‑Daryani N. The
relationship between sexual function and quality of life
in patients with irritable bowel syndrome. Govaresh
2014;18:216‑23.
24. Wexler DJ, Grant RW, Wittenberg E, Bosch JL, Cagliero E,
Delahanty L, et al. Correlates of health‑related quality of life in
type 2 diabetes. Diabetologia 2006;49:1489‑97.
25. Lloyd A, Sawyer W, Hopkinson P. Impact of long‑term
complications on quality of life in patients with type 2 diabetes
not using insulin. Value Health 2001;4:392‑400.
26. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab
Res Rev 1999;15:205‑18.
27. Yekta Z, Pourali R, Ghasemi‑Rad M. Comparison of demographic
and clinical characteristics influencing health‑related quality of
life in patients with diabetic foot ulcers and those without foot
ulcers. Diabetes Metab Syndr Obes 2011;4:393‑9.
28. EnzlinP, MathieuC, Van den BruelA, Bosteels J, VanderschuerenD,
Demyttenaere K. Sexual dysfunction in women with type 1
diabetes: A controlled study. Diabetes Care 2002;25:672‑7.
29. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R,
et al. The Female Sexual Function Index (FSFI): A multidimensional
self‑report instrument for the assessment of female sexual
function. J Sex Marital Ther 2000;26:191‑208.
30. Ware JE Jr, Sherbourne CD. The MOS 36‑item short‑form health
survey (SF‑36). I. Conceptual framework and item selection. Med
Care 1992;30:473‑83.
31. Mohamadi KH, Heidari M, Faghihzadeh S. Validity of Persian
Female Sexual Function Index (FSFI). Payesh J Iran Inst Health
Sci Res 2008;2:269‑78.
32. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short
Form Health Survey (SF‑36): Translation and validation study of
the Iranian version. Qual Life Res 2005;14:875‑82.
33. Wiegel M, Meston C, Rosen R. The Female Sexual Function
Index (FSFI): Cross‑validation and development of clinical cut
off scores. J Sex Marital Ther. 2005;31 (1):1‑20.
34. Thommasen HV, Berkowitz J, Thommasen AT, Michalos AC.
Understanding relationships between diabetes mellitus and
health‑related quality of life in a rural community. Rural Remote
Health 2005;5:441.
35. Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM,
ClouseRE. Depression and poor glycemic control: A meta‑analytic
review of the literature. Diabetes Care 2000;23:934‑42.
36. Mayou R, Bryant B, Turner R. Quality of life in
non‑insulin‑dependent diabetes and a comparison with
insulin‑dependent diabetes. J Psychosom Res 1990;34:1‑11.
37. Lindqvist R, Sjödén PO. Coping strategies and quality of
life among patients on continuous ambulatory peritoneal
dialysis (CAPD). J Adv Nurs 1998;27:312‑9.
38. Ziaei‑Rad M, Vahdaninia M, Montazeri A. Sexual dysfunctions in
patients with diabetes: A study from Iran. Reprod Biol Endocrinol
2010;8:50.
39. Wallner LP, Sarma AV, Kim C. Sexual functioning among women
with and without diabetes in the Boston Area Community Health
Study. J Sex Med 2010;7 (2 Pt 2):881‑7.
40. Enzlin P, Mathieu C, Van Den Bruel A, Vanderschueren D,
Demyttenaere K. Prevalence and predictors of sexual dysfunction
in patients with type 1 diabetes. Diabetes Care 2003;26:409‑14.
41. Bitzer J, Alder J. Diabetes and female sexual health. Womens
Health (Lond Engl) 2009;5:629‑36.42. Moore RH, Sarwer DB, Lavenberg JA, Lane IB, Evans JL, Volger S,
et al. Relationship between sexual function and quality of life in
obese persons seeking weight reduction. Obesity (Silver Spring)
2013;21:1966‑74.
43. Merghati Khoei E, Qaderi K, Amini L, Haghani H. Relationship
between sexual function and quality of life in multiple sclerosis.
IJOGI 2012;15:7‑14.
44. Tepavcevic DK, Kostic J, Basuroski ID, Stojsavljevic N,
Pekmezovic T, Drulovic J. The impact of sexual dysfunction on the
quality of life measured by MSQoL‑54 in patients with multiple
sclerosis. Mult Scler 2008;14:1131‑6.
45. Monjamed Z, Asqharpoor MA, Mehran A, Peimani T. The quality
of life in diabetic patients with chronic complications. Hayat
2006;12:55‑66.
46. Abu Ali RM, Al Hajeri RM, Khader YS, Shegem NS, Ajlouni KM.
Sexual dysfunction in Jordanian diabetic women. Diabetes Care
2008;31:1580‑1.
47. Fatemi SS, Taghavi SM. Evaluation of sexual function in
women with type 2 diabetes mellitus. Diab Vasc Dis Res
2009;6:38‑9.
48. Saadatjoo SA, Rezvanee MR, Tabyee SH, Oudi D. Life quality
comparison in type 2 diabetic patients and none diabetic persons.
Mod Care 2012;9:24‑31.
49. Ghasemi‑Pour M, Ghasemi V, Zamani A. Study of life quality
in the patients with diabetes referred to Khorramabad Shohada
hospital in 2008. Yafteh 2009;11:125‑33.
Atherton PJ, et al. Impacting quality of life for patients with
advanced cancer with a structured multidisciplinary intervention:
A randomized controlled trial. J Clin Oncol 2006;24:635‑42.
2. Darvishpoor KakhkiA, Abed SaeediZ, Yaghmaie F, Alavi Majd H,
Montazeri A. Survey correlation between quality of life and
disease and demographic variables of diabetic patients referred
to Tehran hospitals in 2004. Iran J Endocrinol Metab 2006;8:49‑56.
3. Darban F. The Effect of Stress Inoculation Program on the Quality
of Life of Nurses Working in Psychiatric Wards: Mashhad
University Of Medical Science; 2012.
4. Sadabadi MH, Babapour Kheirodin J. Comparison of quality of
life and coping strategies in diabetic and nondiabetic people.
J Shahid Sadoughi Univ Med Sci 2012;20:581‑92.
5. Ahmadi A, Zade JH, Madise MR, Lashkari L. Effective factors
in the quality of life in patients with type 2 diabetes. J North
Khorasan Univ Med Sci 2011;3:7‑13.
6. Lam CL, Lauder IJ. The impact of chronic diseases on the
health‑related quality of life (HRQOL) of Chinese patients in
primary care. Fam Pract 2000;17:159‑66.
7. Soltan Ahmadi ZH, Ranjbar H, Kohan M. The relationship
between sexual function of diabetic women with quality of life.
J Shahid Beheshti Univ Med Sci 2013;23:32‑9.
8. Hisasue S, Kumamoto Y, Sato Y, Masumori N, Horita H, Kato R,
et al. Prevalence of female sexual dysfunction symptoms and its
relationship to quality of life: A Japanese female cohort study.
Urology 2005;65:143‑8.
9. Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual
dysfunction: Current perspectives. Diabetes Metab Syndr Obes
2014;7:95‑105.
10. Ramezani M, Dolatian M, Shams J, Alavi H. The relationship
between self‑esteem and sexual dysfunction and satisfaction in
women. Arak Med Univ J 2012;14:57‑65.
11. Zeighami Mohammadi SH, Ghaffar F. Sexual dysfunction and
its correlation with quality of life among women affected with
cancer. Iran J Obstet Gynecol Infertil 2009;12:39‑46.
12. Veronelli A, Mauri C, Zecchini B, Peca MG, Turri O, Valitutti MT,
et al. Sexual dysfunction is frequent in premenopausal women
with diabetes, obesity, and hypothyroidism, and correlates with
markers of increased cardiovascular risk. A preliminary report.
J Sex Med 2009;6:1561‑8.
13. Lowenstein L, Pierce K, Pauls R. Urogynecology and sexual
function research. How are we doing? J Sex Med 2009;6:199‑204.
14. Raina R, Pahlajani G, Khan S, Gupta S, Agarwal A, Zippe CD.
Female sexual dysfunction: Classification, pathophysiology, and
management. Fertil Steril 2007;88:1273‑84.
15. Kiadaliri AA, Najafi B, Mirmalek‑Sani M. Quality of life in people
with diabetes: A systematic review of studies in Iran. J Diabetes
Metab Disord 2013;12:54.
16. Diabetes Atlas 2012: 371 Million Cases Worldwide; 2015 Available
from: HYPERLINK “http://www.jnj.com/sites/default/files/
pdf/Facts‑About‑Diabetes‑Infographic.pdf” http://www.jnj.
com/sites/default/files/pdf/Facts‑About‑Diabetes‑Infographic.
pdf. [Last updated on 2015 May 12; Last cited on 2015 May 14].
17. Shaw JE, SicreeRA, Zimmet PZ. Global estimates of the prevalence
of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87:4‑14.
18. Siddiqu MA, Ahmed Z, Ahmed‑Khan A. Psychological impact
on sexual health among diabetic patients: A review. Int J Diabetes
Res 2012;1:28‑31.
19. Shi YF, Shao XY, Lou QQ, Chen YJ, Zhou HJ, Zou JY. Study on
female sexual dysfunction in type 2 diabetic Chinese women.
Biomed Environ Sci 2012;25:557‑61.
20. Enzlin P, Rosen R, Wiegel M, Brown J, Wessells H, Gatcomb P,
et al. Sexual dysfunction in women with type 1 diabetes:
Long‑term findings from the DCCT/EDIC study cohort. Diabetes
Care 2009;32:780‑5.
21. Pontiroli AE, Cortelazzi D, Morabito A. Female sexual dysfunction
and diabetes: A systematic review and meta‑analysis. J Sex Med
2013;10:1044‑51.
22. Walsh KE, Berman JR. Sexual dysfunction in the older woman:
An overview of the current understanding and management.
Drugs Aging 2004;21:655‑75.
23. Noosh‑Abadi AN, Rezaei O, Ebrahimi‑Daryani N. The
relationship between sexual function and quality of life
in patients with irritable bowel syndrome. Govaresh
2014;18:216‑23.
24. Wexler DJ, Grant RW, Wittenberg E, Bosch JL, Cagliero E,
Delahanty L, et al. Correlates of health‑related quality of life in
type 2 diabetes. Diabetologia 2006;49:1489‑97.
25. Lloyd A, Sawyer W, Hopkinson P. Impact of long‑term
complications on quality of life in patients with type 2 diabetes
not using insulin. Value Health 2001;4:392‑400.
26. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab
Res Rev 1999;15:205‑18.
27. Yekta Z, Pourali R, Ghasemi‑Rad M. Comparison of demographic
and clinical characteristics influencing health‑related quality of
life in patients with diabetic foot ulcers and those without foot
ulcers. Diabetes Metab Syndr Obes 2011;4:393‑9.
28. EnzlinP, MathieuC, Van den BruelA, Bosteels J, VanderschuerenD,
Demyttenaere K. Sexual dysfunction in women with type 1
diabetes: A controlled study. Diabetes Care 2002;25:672‑7.
29. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R,
et al. The Female Sexual Function Index (FSFI): A multidimensional
self‑report instrument for the assessment of female sexual
function. J Sex Marital Ther 2000;26:191‑208.
30. Ware JE Jr, Sherbourne CD. The MOS 36‑item short‑form health
survey (SF‑36). I. Conceptual framework and item selection. Med
Care 1992;30:473‑83.
31. Mohamadi KH, Heidari M, Faghihzadeh S. Validity of Persian
Female Sexual Function Index (FSFI). Payesh J Iran Inst Health
Sci Res 2008;2:269‑78.
32. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short
Form Health Survey (SF‑36): Translation and validation study of
the Iranian version. Qual Life Res 2005;14:875‑82.
33. Wiegel M, Meston C, Rosen R. The Female Sexual Function
Index (FSFI): Cross‑validation and development of clinical cut
off scores. J Sex Marital Ther. 2005;31 (1):1‑20.
34. Thommasen HV, Berkowitz J, Thommasen AT, Michalos AC.
Understanding relationships between diabetes mellitus and
health‑related quality of life in a rural community. Rural Remote
Health 2005;5:441.
35. Lustman PJ, Anderson RJ, Freedland KE, de Groot M, Carney RM,
ClouseRE. Depression and poor glycemic control: A meta‑analytic
review of the literature. Diabetes Care 2000;23:934‑42.
36. Mayou R, Bryant B, Turner R. Quality of life in
non‑insulin‑dependent diabetes and a comparison with
insulin‑dependent diabetes. J Psychosom Res 1990;34:1‑11.
37. Lindqvist R, Sjödén PO. Coping strategies and quality of
life among patients on continuous ambulatory peritoneal
dialysis (CAPD). J Adv Nurs 1998;27:312‑9.
38. Ziaei‑Rad M, Vahdaninia M, Montazeri A. Sexual dysfunctions in
patients with diabetes: A study from Iran. Reprod Biol Endocrinol
2010;8:50.
39. Wallner LP, Sarma AV, Kim C. Sexual functioning among women
with and without diabetes in the Boston Area Community Health
Study. J Sex Med 2010;7 (2 Pt 2):881‑7.
40. Enzlin P, Mathieu C, Van Den Bruel A, Vanderschueren D,
Demyttenaere K. Prevalence and predictors of sexual dysfunction
in patients with type 1 diabetes. Diabetes Care 2003;26:409‑14.
41. Bitzer J, Alder J. Diabetes and female sexual health. Womens
Health (Lond Engl) 2009;5:629‑36.42. Moore RH, Sarwer DB, Lavenberg JA, Lane IB, Evans JL, Volger S,
et al. Relationship between sexual function and quality of life in
obese persons seeking weight reduction. Obesity (Silver Spring)
2013;21:1966‑74.
43. Merghati Khoei E, Qaderi K, Amini L, Haghani H. Relationship
between sexual function and quality of life in multiple sclerosis.
IJOGI 2012;15:7‑14.
44. Tepavcevic DK, Kostic J, Basuroski ID, Stojsavljevic N,
Pekmezovic T, Drulovic J. The impact of sexual dysfunction on the
quality of life measured by MSQoL‑54 in patients with multiple
sclerosis. Mult Scler 2008;14:1131‑6.
45. Monjamed Z, Asqharpoor MA, Mehran A, Peimani T. The quality
of life in diabetic patients with chronic complications. Hayat
2006;12:55‑66.
46. Abu Ali RM, Al Hajeri RM, Khader YS, Shegem NS, Ajlouni KM.
Sexual dysfunction in Jordanian diabetic women. Diabetes Care
2008;31:1580‑1.
47. Fatemi SS, Taghavi SM. Evaluation of sexual function in
women with type 2 diabetes mellitus. Diab Vasc Dis Res
2009;6:38‑9.
48. Saadatjoo SA, Rezvanee MR, Tabyee SH, Oudi D. Life quality
comparison in type 2 diabetic patients and none diabetic persons.
Mod Care 2012;9:24‑31.
49. Ghasemi‑Pour M, Ghasemi V, Zamani A. Study of life quality
in the patients with diabetes referred to Khorramabad Shohada
hospital in 2008. Yafteh 2009;11:125‑33.
)