Discussion
The most important observation in this study was the
very low perceived mental and physical health in diabetic
patients on dialysis compared with the non-diabetic dialysis
patients. The HRQOL in these diabetic patients on
dialysis was poorer not only than patients without diabetes,
but was also poorer than other diabetes patients
not receiving dialysis, as well as diabetes patients with
foot ulcers. The severity of complications in diabetes
patients has been shown to be associated with a lower
HRQOL [5,22]. In our study, it appears that SF-36 was
sensitive enough to differentiate between two major
complications of diabetes. Both vitality and general
health were perceived to be lower in diabetic patients on
dialysis compared to the diabetic patients with foot
ulcers. Both subscales have been recognised as suitable