Introduction:
Comorbidity of depression and type 2 diabetes is common. Less is known about metabolic impairment in association with milder forms of mental health issues, such as psychological distress (PD) and health locus of control (HLoC).
Hypothesis:
To cross-sectionally assess the hypothesis that PD and low HLoC are associated with insulin resistance in a Swedish population.
Methods:
In 2002-2005, a random sample of 2816 men and women aged 30-74 years participated (76%) in a survey in two municipalities in southwestern Sweden. Participants answered questionnaires, performed an OGTT and had anthropometric measurements taken. PD was measured by the validated 12-item General Health Questionnaire. HLoC was measured with the question ‘‘Do you believe that you can do anything yourself in order to preserve good health?”. PD and HLoC were both dichotomized and then combined into a risk score to indicate if the participants were positive for
none
of the factors, for either
HLoC
or
PD
, or for
both
. Insulin resistance was estimated by HOMA-ir. For the present study, 2714 subjects without previously known diabetes were included.
Results:
In general linear models, using
none
as reference (Table I), associations with HOMA-ir were seen for participants with either
PD
or
HLoC,
as well as for those with
both
. The strongest association was seen for
both
and this association remained, as did that for
HLoC,
when adjusting for multiple confounders. However, when adding physical activity to the model (Table I) the association was lost also for those positive solely for
HLoC
compared to those positive for
none
of the factors. In fact, a multiplicative effect on HOMA-ir was indicated with regard to having
both
factors (Table I).
Conclusions:
In the present study, a combination of psychological distress and low health locus of control was significantly associated with insulin resistance, highlighting the importance of further implementation of health psychology in primary care in order to prevent type 2 diabetes and ultimately cardiovascular disease.
Use of health locus of control on self‐management and HbA1c in patients with type 2 diabetes
