Association of Higher Rates of Type 2 Diabetes (T2DM) Complications with Psychological and Demographic Variables: Results of a Cross-Sectional Study

Abstract

Introduction

The aim of this study was to assess the relationship between the occurrence and number of T2DM complications with sociodemographic (age, sex, habitation, education), clinical (duration of diabetes, HbA1c (%), BMI) and psychological (well-being, sense of influence on the diabetes course, coping styles) variables.

Methods

A total of 2574 adult patients were assessed using The Sense of Influence on the Diabetes Course Scale, WHO-5 Well-Being Index, and the Brief Method of Evaluating Coping with Disease. Hierarchical Regression Analysis was conducted with number of complications as the dependent variable and three sets of variables entered in sequential steps: (a) sociodemographic; (b) clinical and (c) psychological factors. Logistic regression analysis was used to examine the association of these variables with diabetes complications’ occurrence.

Results

A higher number of complications and higher odds ratios of occurrence of complications were associated with sociodemographic and clinical variables, poor well-being, low perception of influence on the diabetes course, and an emotion-oriented coping style. The logistic regression indicated that participants with HbA1c >7% (in comparison with HbA1c ≤ 7%) and with high risk of depression (in comparison with no risk of depression) had respectively 68% and 86% higher odds of developing complications.

Discussion

The number of complications has weak but statistically significant relations with psychological and clinical factors.

Conclusion

The results support the rationale of including the psychosocial factors in the context of diabetes management.

Keywords:

• type 2 diabetes
• glycemic control
• psychosocial factors
• HbA_1c
• diabetes complications
• well-being

Acknowledgments

The research is based on selected data from a database of the study “Psychosocial factors related to adherence to the recommendations of therapy with two-phase insulin analogues.” The Foundation for the Development of Psychiatry and Psychotherapy in Warsaw was the sponsor of the project within the meaning of the GCP and carried out the study, which was also approved by the Bioethics Committee of the Medical University of Warsaw. The used data was previously analyzed by Agnieszka Łukasiewicz, MD, in her PhD thesis entitled “Relations of psychological and sociodemographic factors with general characteristics of the diabetes course: current – level of glycated hemoglobin and Body Mass Index and longterm – number of complications.” The thesis was prepared under the supervision of Łukasz Gawęda and it was defended in 2019 at the 2nd Faculty of Medicine, Medical University of Warsaw.

Disclosure

Andrzej Kokoszka received an honorarium as the principal investigator of the study “Psychosocial factors related to adherence to the recommendations of therapy with two-phase insulin analogues”, after applying for a research grant from Novo Nordisk, Poland, for the Foundation for the Development of Psychiatry and Psychotherapy in Warsaw. Novo Nordisk Poland sponsored his participation in a meeting of Psychosocial Aspects of Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Powered by TCPDF (www.tcpdf.org) of Diabetes (PSAD) Study Group. The PSAD Study Group is an official Study Group of the European Association for the Study of Diabetes (EASD). The authors report no other conflicts of interest in this work.