Background
Diabetes is common in the older population of African countries. Diabetes and its complications impact on quality of life and causes disability, which may affect an individual’s capacity to manage and maintain longer-term health and well-being.
Objectives
To examine the association between health-related QoL and disability with diabetes status, sociodemographic characteristics, health risk behaviours and comorbid conditions in older adults  with diabetes in South Africa.  
Methods
Secondary analyses of survey data from the South Africa survey of participants aged > 50 years in Wave 1 (2007–2008) of the Study of Global Ageing and Adult Health (SAGE). Multivariate regressions describe the relationship between diabetes, sociodemographic factors, health risk behaviours and coexisting chronic conditions and quality of life (WHOQoL) and functional ability (WHODASi).
Results 
Mean age (SD) was 61.6 (9.5) years; 55.9% were women. Prevalence of self-reported diabetes was 9.2%. Having diabetes resulted in poorer WHOQoL scores (-4.2, 95%Cl (-9.2;0.9)). A gradient reduction in WHOQoL was found with increasing comorbidity in both diabetic and non-diabetic groups. Higher levels of education and physical activity were correlated with high WHOQoL scores: >13 years of. education (5.0 (1.9;8.0)) and higher physical activity (8.1 (2.6;13.6)), (p <0.001). Overall, being older, being unmarried, having chronic conditions and having less education were associated with a higher chance of disability.The odds of disability increased with less wealth, never having worked, alcohol use, lower physical activity and having chronic conditions. Odds of a high disability score reduced by 30% in participants with diabetes with a high level of physical activity, compared to those who were less physically active. 
Conclusions
Diabetes negatively impacts QoL and disability status in South Africa, particularly in individuals with low socioeconomic status, and where comorbid conditions are present. Sustainable policies are needed to improve QoL and reduce disability through promotion of healthy eating

Health related quality of life and functional disability among South African older adults with diabetes: (SAGE) Wave 1