Treatment Adherence and Health-Related Quality of Life Among Patients with Type 2 Diabetes Mellitus in Rajshahi, Bangladesh: A Cross-Sectional Study

Background Type 2 diabetes mellitus (T2DM) is a rapidly growing public health crisis in Bangladesh, where an estimated 13.1 million adults were living with the condition in 2021, with projections suggesting this figure will nearly 22.3 million by 2045. Poor medication adherence and impaired health-related quality of life (HRQoL) are recognized consequences of long-term T2DM management, yet data from northwestern Bangladesh remain scarce. This study aimed to assess treatment adherence, HRQoL and identify their associated factors among T2DM patients in Rajshahi, Bangladesh. Methods We conducted a cross-sectional study between January and December 2021 among 205 T2DM patients from two tertiary-level hospitals in Rajshahi. Treatment adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8), and HRQoL was measured using the EuroQol-5 Dimensions Questionnaire (EQ-5D-5L). Results The mean age of participants was 54.43 ({+/-}10.75) years; 50.73% were female. The majority (85.85%) had HbA1c [≥]6.5%, reflecting widespread poor glycaemic control. Regarding treatment adherence, 40.98% of patients had low adherence, 26.83% had medium adherence, and 32.19% had high adherence. In terms of HRQoL, only 6.83% were in perfect health state, while 52.68% had slight/moderate problems and 40.49% had severe/extreme problems across EQ-5D-5L domains. The association between treatment adherence and HRQoL was not statistically significant (p=0.265). Multiple regression analysis (Adjusted R{superscript 2}=0.620) identified diabetic complications, illiteracy, primary education, female gender, higher BMI, joint family type, treatment adherence, older age, and two antidiabetic medications as significant predictors of poorer HRQoL, while urban residence and family history of DM were independently associated with better HRQoL. Conclusions A substantial proportion of T2DM patients exhibited low treatment adherence and markedly impaired HRQoL. While adherence and HRQoL were not directly associated, diabetic complications emerged as the strongest independent predictor of poor quality of life. These findings highlight the urgent need for multidisciplinary interventions to prevent complications in this population.