{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:38:09Z","timestamp":1792456689498,"version":"4.5.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Understanding the coexistence of diabetes-related complications and their impact on quality of life can help guide healthcare strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The purpose of this study was to assess the prevalence and coexistence of diabetes-related complications and their association with health-related quality of life (HRQoL) in patients with type 2 diabetes (T2D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study of 1,703 patients with T2D receiving standard care in primary healthcare units in Mexico. Diabetes-related complications assessed included peripheral neuropathy, retinopathy, chronic kidney disease, cardiovascular disease, and amputation history. HRQoL was measured using the EuroQol 5-Dimension 5-Level questionnaire. Multivariable regression analyses were used to adjust for confounders and assess associations with HRQoL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Complications were present in 70.5% of patients, predominantly peripheral neuropathy. The most affected HRQoL dimensions were pain\/discomfort (53.8%) and anxiety\/depression (53.4%), followed by mobility (34.2%), self-care (34%), and usual activities (24.2%). Multivariable analysis showed female sex was independently associated with a higher likelihoodof reporting problems across all dimensions. Having at least one complication was also associated with impairment, except for anxiety\/depression, where risk increased with two or more complications. Hypertension and use of insulin were associated with a higher risk of problems in mobility, selfcare, and usual activities. Longer diabetes duration and use of insulin were risk factors for pain\/discomfort, while higher body mass index was associated with anxiety\/depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diabetes-related complications are highly prevalent and affect HRQoL domains in primary care, with a greater burden as complications accumulate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcdhc.2026.1773692","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:22:21Z","timestamp":1773328941000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Cumulative burden of diabetes-related complications and health-related quality of life in primary care: a cross-sectional study from Mexico"],"prefix":"10.3389","volume":"7","author":[{"given":"Ruben","family":"Silva-Tinoco","sequence":"first","affiliation":[{"name":"Unidad de Atenci\u00f3n a la Salud, Servicios P\u00fablicos de Salud del Instituto Mexicano del Seguro Social para el Bienestar","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilia","family":"Castillo-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Galindez-Fuentes","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Especializada en el Manejo de la Diabetes en la Ciudad de M\u00e9xico, Servicios P\u00fablicos de Salud del Instituto Mexicano del Seguro Social para el Bienestar","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Avalos-Bracho","sequence":"additional","affiliation":[{"name":"Unidad de Atenci\u00f3n a la Salud, Servicios P\u00fablicos de Salud del Instituto Mexicano del Seguro Social para el Bienestar","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward\u00a0W","family":"Gregg","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences","place":["Dublin, Ireland"]},{"name":"Imperial College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Cuatecontzi-Xochitiotzi","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Especializada en el Manejo de la Diabetes en la Ciudad de M\u00e9xico, Servicios P\u00fablicos de Salud del Instituto Mexicano del Seguro Social para el Bienestar","place":["Mexico 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