Are psychopathological features relevant predictors of glucose control in patients with type 2 diabetes? A prospective study

Abstract

Type 2 diabetes has been associated with an increased prevalence of psychopathology, in comparison with matched non-diabetic controls. However, the cross-sectional design of most studies does not allow causal inferences. The aim of the present study is the exploration of this possible association in patients with type 2 diabetes, in a longitudinal fashion. This prospective observational study was conducted on a consecutive series of 250 type 2 diabetic outpatients and a 1-year follow-up period was performed. At enrollment, a complete medical history was collected and hemoglobin A1c was measured. General psychopathology was assessed using the Symptom Checklist 90-revised and the Eating Disorder Examination Questionnaire. Among the 187 patients available at follow-up, factors associated with unsatisfactory glycemic control at follow-up were baseline hemoglobin A1c, insulin therapy, a longer duration of diabetes, higher scores on the Eating behavior, and Somatization scales. At multivariate analysis, the attainment of hemoglobin A1c ≤ 7 % was associated with baseline hemoglobin A1c (p = 0.01), insulin therapy (p = 0.016), and Eating behavior (p = 0.02), whereas duration of diabetes and Somatization were no longer significant after adjusting for confounders. The results of the present study suggest that clinical features have a much greater impact on attainment of therapeutic goals than psychopathology. However, there are several aspects, such as temperament, motivation, self-efficacy, and well-being, not assessed in the present study, which could be crucial. These areas should be adequately explored for obtaining an overall picture of the psychological determinants of appropriate metabolic control in diabetes.

The Florence Emotional Eating Drive (FEED): a validation study of a self-report questionnaire for emotional eating

“…In clinical samples, as expected, scores of FEED were higher in patients with disorders characterized by loss of control over eating, i.e. BN and BED, and lower in those with type 2 diabetes, the majority of whom are not supposed to be affected by relevant eating disorder symptoms [43,44]. Consequently, these results corroborate the concurrent validity of the questionnaire.…”

Relations of Well-Being, Coping Styles, Perception of Self-Influence on the Diabetes Course and Sociodemographic Characteristics with HbA1c and BMI Among People with Advanced Type 2 Diabetes Mellitus

“…These data are consistent with the results of longitudinal studies showing that disease duration, insulin use and baseline HbA1c, rather than psychological variables, were most important for achieving optimal glycated hemoglobin levels. 39 …”

Associations of depression with impaired glucose regulation, newly diagnosed diabetes and previously diagnosed diabetes in Chinese adults

“…Another explanation is that a lifetime history of depression or previous antidepressant treatment might contribute to the onset of diabetes , especially when the population was mainly composed of middle‐aged and elderly participants. Furthermore, patients with diabetes coupled with depression usually have higher blood glucose levels and early occurrence of complications , thus leading to an early diagnosis of diabetes (previously diagnosed diabetes). By contrast, patients with diabetes who did not suffer from depression might have a more favourable metabolic profile, thus having a delayed diagnosis of diabetes (newly diagnosed diabetes).…”

“…Diabetes accompanied by depression often results in poorer metabolic or glycaemic control . Patients with worse glycaemic control may manifest as having diabetes of longer duration or more intensive treatment (such as insulin).…”