Diabetes-Related Symptom Distress in Association With Glucose Metabolism and Comorbidity

The Hoorn Study

  1. Marcel C. Adriaanse, PHD1,
  2. Frans Pouwer, PHD23,
  3. Jacqueline M. Dekker, PHD2,
  4. Giel Nijpels, MD, PHD24,
  5. Coen D. Stehouwer, MD, PHD5,
  6. Robert J. Heine, MD, PHD26 and
  7. Frank J. Snoek, PHD23
  1. 1Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands
  2. 2EMGO Institute, VU University Medical Centre, Amsterdam, the Netherlands
  3. 3Department of Medical Psychology, VU University Medical Centre, Amsterdam, the Netherlands
  4. 4Department of General Practice, VU University Medical Centre, Amsterdam, the Netherlands
  5. 5Department of Internal Medicine, Academic Hospital Maastricht, Maastricht, the Netherlands
  6. 6Department of Endocrinology, VU University Medical Centre, Amsterdam, the Netherlands
  1. Corresponding author: Marcel C. Adriaanse, marcel.adriaanse{at}falw.vu.nl

Abstract

OBJECTIVE—The purpose of this study was to determine the associations between diabetes-related symptom distress, glucose metabolism status, and comorbidities of type 2 diabetes.

RESEARCH DESIGN AND METHODS—This was a cross-sectional sample of 281 individuals with normal glucose metabolism (NGM), 181 individuals with impaired glucose metabolism (IGM), and 107 subjects with type 2 diabetes. We used the revised type 2 Diabetes Symptom Checklist (DSC-R) to assess diabetes-related symptom distress.

RESULTS—The total symptom distress score (range 0–100) was relatively low for diabetic subjects (mean ± SD 8.4 ± 9.4), although it was significantly different from that for subjects with IGM (6.5 ± 7.1) and NGM (6.1 ± 7.9) (F = 3.1, 2 d.f., P = 0.046). Ischemic heart disease was associated with elevated DSC-R scores on three subscales, whereas depression showed higher symptom distress levels across all DSC-R domains.

CONCLUSIONS—Worsening glucose metabolism is associated with increasing diabetes-related symptom distress. This relationship is attenuated by ischemic heart disease and particularly by depression.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 26 August 2008.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted August 15, 2008.
    • Received June 13, 2008.
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  1. Published online before print August 26, 2008, doi: 10.2337/dc08-1074 Diabetes Care December 2008 vol. 31 no. 12 2268-2270
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