OBJECTIVES: In this patient-centered cross-sectional survey, we aimed at measuring self-reported health status of people with diabetes in France and analyzed independent risk factors for lower self-reported health status.

METHODS: The survey analysis included 130 people with type 1 and 150 people with type 2 diabetes in France. Perceived health status was assessed by a global health question on a Likert-scale of 1 to 5 (excellent=1, to 5=poor). In a multivariate regression, risk factors of low health status were block-wise analyzed: demographics (age, sex,) socioeconomic status (years of education, employment status, size of city), diabetes-specific variables (diabetes type, diabetes duration, treatment regimen), complications (diabetes-specific and other complications) and psychosocial variables (diabetes treatment satisfaction, diabetes distress). The sample was weighted according to the age distribution of the French population (INSEE report 2021).

RESULTS: The mean general health score was 3.3 ± 0.9, suggesting poorer health than average: 1.2% rated their health status as excellent, 13.1% as very good, 49.2% as good, 23.5% as fair and 13.0% as poor. The multi-variate model explained one third (R²=35.6%) of the variance of the health status. Lower health status was poorly associated with demographic (ΔR²= 1.0%, p=0.216) or diabetes specific variables (ΔR²= 2.6%, p=0.051) whereas socio-economic variables (ΔR²= 13.9%, p<0.001), prevalent complications (ΔR²= 7.3%, p<0.001) and psychosocial variables (ΔR²= 10.8%, p<0.001) explained a significant proportion of the variance. Diabetes distress (ß=0.29, p<0.001) and employment status (ß=-0.25, p<0.001) were the most significant predictors.

CONCLUSIONS: Survey participants reported a rather low health status, mainly driven by socioeconomic (especially employment status) and psychosocial factors (especially diabetes distress). Together, these variables explained two-thirds (24.7%) of the variance in health status. Consequently, job-status and diabetes distress, rather than diabetes-specific variables or medical conditions, are the main determinants of perceived health status of people with diabetes in France.