# Impact on the Quality of Life and Physiological Parameters in Patients with Diabetes Mellitus
## 4 Discussion
In addition, the presence of emotional disorders is associated with a decrease of up to three times to the adherence to treatment with the consequent development of complications associated with the disease [29], which is a serious concern because polypharmacy and other related comorbidities such as dyslipidaemia are very common in elderly people with type 2 diabetes mellitus [31; 32]. According to [PERSON] et al. [33], it is the physical limitation that triggers the development of emotional imbalance, depression and anxiety. This is more frequent in women than in men. [PERSON] et al. [34] explained their outcomes by presenting two arguments: the women in their study group presented a higher risk of comorbidities, and they were overloaded by the combination of housework and labour activities. [PERSON] et al. [35], sustained that women would interpret their health status differently due to culturally established roles of genders. Actually, these arguments are consistent with daily life in many countries, where equal sharing of tasks and housework is not very common. After retirement, women tend to be more active and are more limited than men in the presence of diabetes complications. It is, therefore, relevant to identify the origin of these differences in order to prevent complications arising from this situation. In DM, the high prevalence of vascular pathology together with the high rate of complications associated with this phenomenon places diabetic vascular disease, as dyslipidaemia, among the most influential complications concerning well-being [32; 36]. These data can be seen in our results, where their presence significantly affects almost all of the components or scales analysed in the SF-36, confirmed in recent studies such as the one carried out by [PERSON] et al. [22]. As described by [PERSON] et al. [37], we understand that diabetic patients who have asymptomatic arterial disease are unaware of the evolution and sometimes the presence of this condition. According to our results, when analysing the dimensions of the SF-36, the presence of vascular symptomatology causes significant differences in previously unaffected HRQL scales, such as \"vitality\", \"general health\" and \"mental health\". Moreover, it is interesting that, in this case, when we analysed the data by gender differentiation, it was the only time that women had better results than men, in parameters such as \"vitality\" or \"mental health\". This phenomenon is supported by authors such as [PERSON] et al. [38], who explained it via the relationship of vascular disorders and the development of erectile dysfunction and the impact this had on the perception of vitality among their male study group. In our work, we have not obtained statistically significant results that allow us to accept that there is a direct relationship between the presence of neuropathy and changes in the different levels of well-being. However, studies with a larger sample have established associations between the two variables. According to [PERSON] et al. [36], it is the only complication in which the impact of the mental component is greater than the physical component, and in more severe conditions, the two will be equalised. This results in a greater impact on all of the scales of the HRQL study. Thus, for example, with the onset of neuropathic pain or loss of proprioceptive sensitivity, there would be a decrease in the physical assessment [39], as we observed in our descriptive study when comparing the groups according to gender. Despite this, we found no evidence to study possible differences between men and women in relation to peripheral neuropathy, so we cannot cross-check the data obtained. The lack of such studies may be due to the different proportion of men and women with neuropathy. Men are more frequently affected by this complication. In our sample, half of the male group had neuropathy and only 20% of the female group did.