Psychosocial factors predict type 2 diabetes mastery

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Ski ◽  
K McGuigan ◽  
A Hill ◽  
V Coates ◽  
D.R Thompson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Process Model ◽  
Short Form ◽  
Depression Scale ◽  
Psychosocial Interventions ◽  
Analytical Framework ◽  
Diabetes Empowerment ◽  
The Impact ◽  
The Relationship

Abstract Background Psychosocial aspects of chronic diseases such as Type 2 diabetes (T2D) and cardiovascular disease (CVD) are increasingly recognised as impacting effective self-management. Until now, little was known regarding the moderating effects of empowerment and depression on the relationship between diabetes-specific distress and mastery. Purpose To evaluate the potential mediating role of diabetes empowerment and depression on the relationship between diabetes-specific distress and mastery. Methods Sample comprised 131 participants diagnosed with T2D, mean [SD] age 62.3 [8.8]; 59.5% male. Mean time since diagnosis was 10.4 years. Assessments included: emotional distress (Problem Areas in Diabetes Scale; PAID); depression and anxiety (Hospital Anxiety and Depression Scale; HADS); mastery (Pearlin Mastery Scale); and empowerment (Diabetes Empowerment Scale – Short Form; DES-SF). Data were examined using SPSS: PROCESS a logistic regression-based path analytical framework for multiple mediator models. Results Regression coefficients for the model identified distress (b=−0.249, t(5,112)=−3.71, p<0.001), empowerment (b=0.280, t(5,112)=3.02, p<0.001) and depression (b=−0.980, t(5,112)=−5.73, p<0.001) were all statistically significant predictors of mastery. The PROCESS model assessed ΔR2 as a result of the interaction between distress and depression, which indicated a significant increase (ΔR2=0.08) in variance explained due to the inclusion of both moderators: F(2,112)=16.88, p<0.001, ΔR2=0.14. Also identified were interaction effect sizes: at low levels of empowerment, increasing depression led to increasing levels of distress predicting overall levels of mastery. This held true at moderate and high levels of empowerment; increasing levels of depression led to increasing distress predicting mastery. Conclusions These findings elucidate the impact of empowerment and depression on the association between distress and mastery in a diabetes cohort. The evidence suggests that the psychosocial interventions likely to have greatest impact on mastery are those that target key moderators such as empowerment and depression. Funding Acknowledgement Type of funding source: None

scholarly journals Meta-Analysis of the Relationship Between Ethnicity, Obesity, and Type 2 Diabetes of Adults in Urban Populations of Central America

2016 ◽  
Vol 5 (3) ◽  
pp. 274
Author(s):  
William G Wuenstel ◽  
James A. Johnson ◽  
James Humphries ◽  
Cheryl Samuel
Keyword(s):  
Type 2 Diabetes ◽  
Relative Risk ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Central American ◽  
Significance Level ◽  
Study Participants ◽  
The Impact ◽  
The Relationship

<table width="593" border="1" cellspacing="0" cellpadding="0"><tbody><tr><td rowspan="2" valign="top" width="387">The purpose of this meta-analysis was to examine the impact of ethnicity and obesity as it relates to Type-2 Diabetes (T2D) in specific Central American countries. A meta-analysis was conducted to determine the association of ethnicity, obesity, and T2D.  Four studies that qualified for inclusion were identified by searching MEDLINE and PubMed databases. The studies on the association of ethnicity and T2D had a combined population resulted in 265,858 study participants. Two studies on the association of obesity and T2D had 197,899 participants. An analysis of the data was conducted utilizing the relative risk ration, odds ratio, and forest plots. The comparison of the relative risk of T2D across ethnic categories by studies range for Blacks was 1.59 to 2.74, Asians was 1.43 to 2.08, and Hispanics .92 to 2.91.  The ethnic difference in the prevalence of diabetes was almost two-fold higher in all ethnic groups than among the Caucasians with a significance level of 95%. A comparison of relative risk of T2D across weight categories was significantly higher among those with a diagnosed of diabetes in all reported areas. The odds ratio was very close to the risk ratio in both ethnicity and obesity to the development of T2D. The meta-analysis findings documented that an association does exist between ethnicity and obesity to the development of type 2 diabetes.</td><td width="0" height="85"> </td></tr><tr><td width="0" height="82"> </td></tr></tbody></table>

scholarly journals Sleep Characteristics in Diabetic Patients Depending on the Occurrence of Neuropathic Pain and Related Factors

2020 ◽  
Vol 17 (21) ◽  
pp. 8125
Author(s):  
Cristina Naranjo ◽  
María Dueñas ◽  
Carlos Barrera ◽  
Guillermo Moratalla ◽  
Inmaculada Failde
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Neuropathic Pain ◽  
Sleep Quality ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Diabetic Patients ◽  
The Relationship

This study aims to compare the sleep characteristics (structure and quality) in patients with type-2 diabetes mellitus with and without diabetic neuropathic pain (DNP), and to investigate the relationship of sensory phenotypes, anxiety, and depression with sleep quality in DNP patients. A cross-sectional study was performed in patients with type-2 diabetes mellitus and neuropathy. Patients were classified into two groups—with or without neuropathic pain—according to the “Douleur Neuropathique-4 (DN4)” scale. Sleep characteristics and quality (Medical Outcomes Study—MOS-sleep), pain phenotype (Neuropathic Pain Symptom Inventory—NPSI), mood status (Hospital Anxiety and Depression scale—HADS), pain intensity (Visual Analogue Scale—VAS), and quality of life (SF-12v2) were measured. The sample included 130 patients (65 with DNP). The mean scores in all the dimensions of the MOS-sleep scale were higher (more disturbances) in the DNP patients. Higher scores in anxiety or depression, greater intensity of pain or a higher score in the paroxysmal pain phenotype were associated with lower sleep quality in DNP patients. A shorter duration of the diabetes and lower levels of glycated hemoglobin were also associated with lower sleep quality. The results show the relationship between DNP and sleep quality, and the importance of assessing sensory phenotypes and mental comorbidities in these patients. Taking these factors into consideration, to adopt a multimodal approach is necessary to achieve better clinical results.

scholarly journals Choice of HbA1c threshold for identifying individuals at high risk of type 2 diabetes and implications for diabetes prevention programmes: a cohort study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren R. Rodgers ◽  
Anita V. Hill ◽  
John M. Dennis ◽  
Zoe Craig ◽  
Benedict May ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Predictive Value ◽  
Absolute Risk ◽  
Parametric Survival Model ◽  
Prevention Programmes ◽  
Parametric Survival ◽  
The Impact ◽  
The Relationship

Abstract Background Type 2 diabetes (T2D) is common and increasing in prevalence. It is possible to prevent or delay T2D using lifestyle intervention programmes. Entry to these programmes is usually determined by a measure of glycaemia in the ‘intermediate’ range. This paper investigated the relationship between HbA1c and future diabetes risk and determined the impact of varying thresholds to identify those at high risk of developing T2D. Methods We studied 4227 participants without diabetes aged ≥ 40 years recruited to the Exeter 10,000 population cohort in South West England. HbA1c was measured at study recruitment with repeat HbA1c available as part of usual care. Absolute risk of developing diabetes within 5 years, defined by HbA1c ≥ 48 mmol/mol (6.5%), according to baseline HbA1c, was assessed by a flexible parametric survival model. Results The overall absolute 5-year risk (95% CI) of developing T2D in the cohort was 4.2% (3.6, 4.8%). This rose to 7.1% (6.1, 8.2%) in the 56% (n = 2358/4224) of participants classified ‘high-risk’ with HbA1c ≥ 39 mmol/mol (5.7%; ADA criteria). Under IEC criteria, HbA1c ≥ 42 mmol/mol (6.0%), 22% (n = 929/4277) of the cohort was classified high-risk with 5-year risk 14.9% (12.6, 17.2%). Those with the highest HbA1c values (44–47 mmol/mol [6.2–6.4%]) had much higher 5-year risk, 26.4% (22.0, 30.5%) compared with 2.1% (1.5, 2.6%) for 39–41 mmol/mol (5.7–5.9%) and 7.0% (5.4, 8.6%) for 42–43 mmol/mol (6.0–6.1%). Changing the entry criterion to prevention programmes from 39 to 42 mmol/mol (5.7–6.0%) reduced the proportion classified high-risk by 61%, and increased the positive predictive value (PPV) from 5.8 to 12.4% with negligible impact on the negative predictive value (NPV), 99.6% to 99.1%. Increasing the threshold further, to 44 mmol/mol (6.2%), reduced those classified high-risk by 59%, and markedly increased the PPV from 12.4 to 23.2% and had little impact on the NPV (99.1% to 98.5%). Conclusions A large proportion of people are identified as high-risk using current thresholds. Increasing the risk threshold markedly reduces the number of people that would be classified as high-risk and entered into prevention programmes, although this must be balanced against cases missed. Raising the entry threshold would allow limited intervention opportunities to be focused on those most likely to develop T2D.

scholarly journals Factors Affecting Quality of Life in Liver Transplant Candidates: An Observational Study

2021 ◽  
Vol 2 (1) ◽  
pp. 64-74
Author(s):  
Ana Isabel López-Lazcano ◽  
Hugo López-Pelayo ◽  
Antoni Gual ◽  
Anna Lligoña ◽  
Vanessa Vilas-Riotorto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Observational Study ◽  
Liver Transplant ◽  
Short Form ◽  
Depression Scale ◽  
Psychosocial Interventions ◽  
Poor Hrqol ◽  
Transplant Candidates ◽  
The Impact

Health-related quality of life (HRQOL) before and after liver transplant (LT) is an important outcome in LT candidates as, in these patients, HRQOL is commonly impaired. However, evidence regarding factors that influence HRQOL in patients with end-stage liver disease is inconclusive. The aim of the present study was to identify factors associated with poor HRQOL. An observational study was conducted over LT candidates. The 36-item Short Form Health Survey (widely used to assess HRQOL) and the Hospital Anxiety and Depression Scale were administered to 211 patients during the pre-transplant assessment. Baseline demographic and clinical data were also collected. Multiple regression analysis was performed to investigate risk factors for poor HRQOL. Female sex (lower B = 7.99 95%C = 0.07–15.92, higher B = 18.09 95%CI = 7.56–28.62), encephalopathy (lower B = −9.45, 95%CI = −14.59–−4.31, higher B = −6.69, 95%CI = −13.13 to −0.25), higher MELD scores (lower B = −1.14, 95%CI = −1.67 to −0.61, higher B = −0.33, 95%CI = −0.65 to −0.12), anxiety (lower B = −3.04 95%C = −4.71 to −1.36, higher B = −1.93 95%CI = −3.39 to −0.47)and depression (lower B = −3.27 95%C = −4.46 to −2.08, higher B = −1.02 95%CI = −1.90 to −0.13) symptoms were associated to poorer HRQOL. Psychosocial interventions should be addressed to liver transplant candidates, especially to women, patients with anxiety, depression or episodes of encephalopathy, in order to prevent the impact that these conditions can have on HRQOL.

scholarly journals Prevalence and Impact of Anxiety and Depression on Type 2 Diabetes in Tunisian Patients over Sixty Years Old

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Jawaher Masmoudi ◽  
Rahma Damak ◽  
Hela Zouari ◽  
Uta Ouali ◽  
Anouar Mechri ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Diabetic Patients ◽  
Good Glycemic Control ◽  
Tunisian Patients ◽  
Control Versus ◽  
The Impact

Objectives. To estimate the prevalence of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) in a population aged over sixty years with type 2 diabetes and to study the impact of anxiety and depression on glycemic balance and disease outcome.Results. The prevalence of anxiety and depression in the 62 subjects included in the study was, respectively, 40.3% and 22.6%. We found a relationship between these disorders and complicated diabetes. The subjects having an imperfectly balanced diabetes had a higher average anxiety score than those having a good glycemic control ( versus ; ). No relationship was found between diabetes balance and depression.Conclusion. Association between anxiety and depressive disorders and diabetes is frequent and worsens patients’ outcome, in terms of diabetes imbalance as well as in terms of diabetic complications. Our study shows that there is need for physicians to detect, confirm, and treat anxiety and depressive disorders in elderly diabetic patients.

scholarly journals Assessing the Impact of Visual Acuity on Quality of Life in Individuals With Type 2 Diabetes Using the Short Form-36

Diabetes Care ◽  
2006 ◽  
Vol 29 (7) ◽  
pp. 1506-1511 ◽  
Author(s):  
P. M. Clarke ◽  
J. Simon ◽  
C. A. Cull ◽  
R. R. Holman
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Visual Acuity ◽  
Short Form ◽  
Short Form 36 ◽  
The Impact

The Relationship Between HbA1c Level and Beck Depression Scale in Patients with Heart Failure with Type 2 Diabetes Mellitus

2018 ◽  
Vol 21 (3) ◽  
pp. 187-192
Author(s):  
Mahmut Yesin ◽  
Metin Çağdaş ◽  
Macit Kalcik ◽  
İbrahim Rencüzoğulları ◽  
Yavuz Karabağ ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Level ◽  
Depression Scale ◽  
Patients With Heart Failure ◽  
The Relationship

The impact of type D personality on the quality of life and on microangiopathic and macroangiopathic complications in outpatients with type 2 diabetes mellitus

2017 ◽  
Vol 41 (S1) ◽  
pp. S491-S492
Author(s):  
V.R. Enatescu ◽  
I. Papava ◽  
R.S. Romosan ◽  
A. Grozavu ◽  
V. Enatescu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Diseases ◽  
Short Form ◽  
Type D Personality ◽  
Type D ◽  
The Impact

IntroductionIn 2015, the worldwide point prevalence for diabetes mellitus was 8.8%. Type D personality was found as being more prevalent in type 2 diabetes than in the general population.ObjectivesWe aimed to reveal the frequency of type D personality and to analyze the impact of type D personality on both quality of life and angiopathic complications, in patients with type 2 diabetes from our region.MethodsA cross-sectional research was performed on 79 outpatients that were monitored for diabetes mellitus at Timisoara diabetes, nutrition and metabolic diseases clinic. Type D personality was assessed with the DS-14 scale. Quality of life was quantified by using the Q-LES-Q-SF scale (Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form). The angiopathic complications were abstracted from medical records.ResultsType D personality was present in 38 subjects with diabetes mellitus (48.10%). Compared to those without type D personality, patients with type D personality and diabetes had significant lower mean scores for the following domains of the Q-LES-Q-SF scale: social relationships (P < 0.001), daily life function (P = 0.027), sexual activity (P = 0.005), to get around physically (P < 0.001), work or hobbies (P = 0.008) and raw score (P = 0.003). Type D personality did not make any difference regarding micro and macroangiopathic complications of type 2 diabetes patients.ConclusionsType D personality, a highly frequent entity, did not make the difference with respect to diabetic complications; however, it may interfere significantly with several facets of the quality of life of these patients. These results should be taken into account for an interdisciplinary approach to these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals A-30 The Relationship Between Mood, Cognitive Shift, and Perseverative Responses in Cognitively Impaired Geriatric Patients

2019 ◽  
Vol 34 (6) ◽  
pp. 889-889
Author(s):  
C Osman
Keyword(s):  
Short Form ◽  
Depression Scale ◽  
Well Being ◽  
Wisconsin Card Sorting Test ◽  
Future Research ◽  
Dementia Severity ◽  
Dynamic Relationship ◽  
The Impact ◽  
Cognitive Shift ◽  
The Relationship

Abstract Objective The current study investigated the relationship between age, sex, vocabulary scores, the number of comorbid medical conditions, cognitive shift scores, perseveration scores, dementia severity, and self-reported anxiety. It was hypothesized a) cognitive shift scores, age, and vocabulary would be inversely related to anxiety b) perseveration scores and dementia severity would be positively correlated to mood. Data Selection Utilizing archival data from a private medical clinic, a sample (N = 114) of Euro-American older adults ages 65-89, presenting for neuropsychological evaluations was obtained. Data included scores from the Wisconsin Card Sorting Test -64 computerized version, the Beck Anxiety Inventory, the Geriatric Depression Scale- short form, and the WAIS-IV vocabulary subtest. Data Synthesis This study utilized a multiple regression analysis. The results suggested age, sex, cognitive shift scores, perseveration scores, and dementia severity had no relationship to anxiety. However, vocabulary was moderately positively correlated with anxiety. It is possible that those with greater vocabulary scores were less severely impacted by their dementia and consequently more aware of their symptoms. Conclusions Focus on neuropsychological data alone was insufficient to understand this complex and dynamic relationship. It is recommended that future research focus on the process itself to gain insight into this bidirectional relationship and various confounding factors, which might have influenced anxiety levels, such as sleep quality and dementia type. The results of this study highlight the importance of understanding the dynamic relationship between cognitive decline due to neurodegenerative diseases and anxiety and the impact the diseases may have on one’s emotional well-being.

scholarly journals Depressive symptoms and quality of life after screening for cognitive impairment in patients with type 2 diabetes: observations from the Cog-ID cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024696 ◽  
Author(s):  
Jolien Janssen ◽  
Paula S Koekkoek ◽  
Geert-Jan Biessels ◽  
Jaap L Kappelle ◽  
Guy E H M Rutten
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Short Form ◽  
Depression Scale ◽  
Analysis Of Covariance

ObjectivesTo assess changes in depressive symptoms and health-related quality of life (HRQOL) after screening for cognitive impairment in people with type 2 diabetes.DesignA prospective cohort study, part of the Cognitive Impairment in Diabetes (Cog-ID) study.SettingParticipants were screened for cognitive impairment in primary care. People suspected of cognitive impairment (screen positives) received a standardised evaluation at a memory clinic.ParticipantsParticipants ≥70 years with type 2 diabetes were included in Cog-ID between August 2012 and September 2014, the current study includes 179 patients; 39 screen positives with cognitive impairment, 56 screen positives without cognitive impairment and 84 participants not suspected of cognitive impairment during screening (screen negatives).Outcome measuresDepressive symptoms and HRQOL assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), 36-Item Short-Form Health Survey, European Quality of Life-5 Dimensions questionnaire and the EuroQol Visual Analogue Scale. Outcomes were assessed before the screening, and 6 and 24 months after screening. An analysis of covariance model was fitted to assess differences in score changes among people diagnosed with cognitive impairment, screen negatives and screen positives without cognitive impairment using a factor group and baseline score as a covariate.ResultsOf all participants, 60.3% was male, mean age was 76.3±5.0 years, mean diabetes duration 13.0±8.5 years. At screening, participants diagnosed with cognitive impairment had significantly more depressive symptoms and a worse HRQOL than screen negatives. Scores of both groups remained stable over time. Screen positives without cognitive impairment scored between the other two groups at screening, but their depressive symptoms decreased significantly during follow-up (mean CES-D: −3.1 after 6 and −2.1 after 24 months); their HRQOL also tended to improve.ConclusionsDepressive symptoms are common in older people with type 2 diabetes. Screening for and a subsequent diagnosis of cognitive impairment will not increase depressive symptoms.

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