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

Diabetes-Related Symptom Distress in Association With Glucose Metabolism and Comorbidity The Hoorn Study Marcel C. Adriaanse , PHD 1 , Frans Pouwer , PHD 2 3 , Jacqueline M. Dekker , PHD 2 , Giel Nijpels , MD, PHD 2 4 , Coen D. Stehouwer , MD, PHD 5 , Robert J. Heine , MD, PHD 2 6 and Frank J. Snoek , PHD 2 3 1 Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands 2 EMGO Institute, VU University Medical Centre, Amsterdam, the Netherlands 3 Department of Medical Psychology, VU University Medical Centre, Amsterdam, the Netherlands 4 Department of General Practice, VU University Medical Centre, Amsterdam, the Netherlands 5 Department of Internal Medicine, Academic Hospital Maastricht, Maastricht, the Netherlands 6 Department of Endocrinology, VU University Medical Centre, Amsterdam, the Netherlands 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 he