Diabetes mellitus is a disease which carries a considerable social impact in Bulgaria and across the world because of its high prevalence. Research literature has recently included lots of studies investigating the effects of diabetes mellitus on the quality of life of diabetic patients and also many instruments to assess these effects. Quality of life is a concept that encompasses an individual‘s subjective perception of physical, emotional and social wellbeing, including both a cognitive component (satisfaction) and an emotional component (happiness). We review and analyse in the present article major determinants of disease-specific quality of life in patients with type 2 diabetes mellitus and the tools used for assessment. RESULTS: Fourteen instruments for measuring quality of life in type 2 diabetes mellitus (T2DM) met our search criteria. Their contents covered different quality-of-life domains or indicators - typical diabetes symptoms, general health and quality of life, personality traits, physical functioning, mental and social well-being, treatment and quality of life. Most of the disease-specific tools had been field tested and data about their reliability and validity have been reported. Few tools had been subjected to formal assessment of their adaptability to changes. CONCLUSIONS: Of the instruments we assessed the most promising approaches for measuring the diabetes-specific quality of life are offered by ADDQoL, DСP and WBQ. Patients were involved in the development of these tools which have been shown by a number of studies to have good internal reliability, external and construct validity. Efforts are being continually made worldwide to develop a standard ensuring valid, reliable, easy to use tool for assessing quality of life in patients with type 2 diabetes mellitus in order to promote patients integration into society.

Introduction: Adipose tissue is immunologically and hormonally active, and these effects are mediated largely by adipocytokines. Thyroid hormones regulate metabolism and organ function, and Hashimoto’s thyroiditis (HT) is the most common autoimmune disease affecting thyroid function. Aim: To evaluate the levels of the adipocytokines leptin and adiponectin in patients with autoimmune HT, and to perform a comparative intragroup analysis in patients with different stages of gland functional activity, and in a control group. Materials and methods: Ninety-five patients with HT and 21 healthy controls were enrolled in the study. Venous blood was taken without anticoagulants after at least 12 hours of fasting, and serum samples were frozen at −70°C until analysis. Serum levels of leptin and adiponectin were determined by an enzyme-linked immunosorbent assay (ELISA). Results: Serum levels of leptin in HT patients were higher than those in the control group (4.5±5.2 ng/mL vs. 1.9±1.3 ng/mL). The hypothyroid patient’s group showed significantly higher levels of leptin than those of the healthy controls (5.1±5.2 ng/mL vs. 1.9±1.3 ng/mL), (p=0.031). Leptin levels correlated positively with body mass index (r=0.533, p<0.001), triglycerides (r=0.223, p=0.033), and immunoreactive insulin (r=0.488, p<0.001) levels. Serum adiponectin concentrations were higher in euthyroid HT patients than in the other groups, but the difference was not statistically significant (p=0.68). We found a positive correlation between adiponectin and HDL cholesterol levels (r=0.442, p<0.001), and negative with body mass index (r=−0.217, p=0.03), and immunoreactive insulin (r=−0.341, p=0.002). Conclusions: The results of this study suggest that leptin has a stronger effect than adiponectin in Hashimoto’s thyroiditis, which can be used to develop new therapeutic agents that modify its effect in the organism.

Together with the epidemic prevalence of diabetes mellitus (DM), the burden of this chronic metabolic disorder has serious impact on the quality of life of patients and reduces their life span. The objective of this study was to assess the impact of type 2 diabetes mellitus (T2DM) on the Quality of Life (QoL) by Audit of Diabetes-Dependent Quality-of-Life (ADDQoL-19). A cross-sectional study of 540 adults with T2DM was carried out. We collected socio-economic, demographic, health status, therapeutic and metabolic control data. The instrument used to measure the quality of life was the ADDQoL-19. The study included 411 adult patients [216 (52.6%) men; mean age 59.9. years]. T2DM had a negative impact on QoL in 36.7% of the participants, whereas 67.1% believed that their life would have been better without the presence of T2DM. The mean ‘present QoL’ score was: 0.6 (SD: 0.9) and the ‘diabetes-related’ QoL was: −1.8 (SD: 0.8). Diabetes had the most negative average weighted impact on ‘freedom to eat’ −4.0 (SD: 2.6), and ‘family life’ −3.9 (SD: 2.7). The results indicate that T2DM has a significant impact on QoL and its assessment is an important tool in the management of this disease. The negative values reflect the general negative impact of diabetes over all 19 examined aspects. These findings are of importance to health professionals and policy makers to identify and implement appropriate interventions in order to achieve better disease management and ultimately to increase the QoL of patients with T2DM.

Diabetes Mellitus is a disease that affects almost every aspect of patients' life. Socio-medical importance and continuously increasing financial costs of diabetes require a thorough research on the quality of life in these patients to optimize clinical management and increase the effectiveness of health interventions. The aim of the study is to assess the quality of life in patients with type 2 diabetes mellitus. Materials and A cross-sectional study was conducted in 90 patients with type 2 diabetes mellitus (T2DM) in Bulgaria. Health-related quality of life was measured using the 36-item Short-Form Health Survey (SF-36). The study result showed that the participants’ age ranged from 32 to 88 years old, with mean of 63.0 years (standard deviation (SD) 0.96). Less than half were females (52.9%), married (74.3%) and living in urban areas (61.4%). Diabetes negative impact is observed on all life aspects. The duration of disease (diabetes duration) and diabetes complication seem to be the most influential factors which negatively and statistically significant affect all the SF-36 subscales. It concluded that better quality of life of patients with diabetes mellitus type 2 is achieved by preventing complications and effective management of chronic underlying diseases.