{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:47:12Z","timestamp":1788540432055,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Health\u2010related quality of life (HRQoL) is a key patient\u2010reported outcome in diabetes care, yet the extent to which somatic and psychological factors are associated with HRQoL remains unclear. This study examined how demographic, diabetes\u2010related, medical, and psychological factors were independently associated with HRQoL in adults with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional online survey was conducted among adults with diabetes in Germany (September 2024\u2013February 2025). HRQoL was assessed using the EuroQol 5\u2010Dimension 5\u2010Level questionnaire (EQ\u20105D\u20105L). Participants also completed the PHQ\u20108 for depressive symptoms, the problem areas in diabetes (PAID) scale, and the hypoglycaemia fear survey (HFS\u2010II). Clinical variables were self\u2010reported and included diabetes type, duration, HbA1c, body mass index (BMI), and complications. Tobit regression accounted for the censored EQ\u20105D distribution. Blockwise multivariable models evaluated incremental explained variance across demographic, diabetes\u2010related, comorbidity, and mental\u2010health domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1581 invitees, 734 completed the EQ\u20105D (mean age 56\u2009\u00b1\u200914\u2009years; 73% type I). In multivariable analyses, female sex (\u03b2\u2009=\u2009\u22120.045), higher BMI (\u03b2\u2009=\u2009\u22120.029), diabetic foot syndrome (\u03b2\u2009=\u2009\u22120.078), neuropathy (\u03b2\u2009=\u2009\u22120.123), and elevated depressive symptoms (\u03b2\u2009=\u2009\u22120.212), diabetes distress (\u03b2\u2009=\u2009\u22120.069), and fear of hypoglycaemia (\u03b2\u2009=\u2009\u22120.085) were all independently associated with lower EQ\u20105D utilities (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Mental\u2010health variables explained a similar proportion of variance (\u224822%) as diabetes\u2010related complications (\u224820%). Mental health factors like depression, diabetes distress, and fear of hypoglycaemia showed highly significant associations with reduced HRQoL by up to 27%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both diabetes complications and mental health determine HRQoL in people with diabetes. Depression emerged as the strongest independent predictor reducing HRQoL by up to 21%. This underscores the importance of mental health for HRQoL. This findings highlight the relevance of integrating mental health assessment into diabetes management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70434","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T03:51:09Z","timestamp":1767844269000},"page":"2383-2392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Independent associations of mental health and diabetes complications with health\u2010related quality of life: Evidence from a cross\u2010sectional study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-2677","authenticated-orcid":false,"given":"Norbert","family":"Hermanns","sequence":"first","affiliation":[{"name":"Research Institute Diabetes Academy Mergentheim (FIDAM)  Bad Mergentheim Germany"},{"name":"Department of Clinical Psychology and Psychotherapy University of Bamberg  Bamberg Germany"},{"name":"diateam  Bad Mergentheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Kittel","sequence":"additional","affiliation":[{"name":"Roche Diagnostics International Ltd.  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