Public Health and Primary CareORIGINAL ARTICLE

Associations between diabetes-related distress and predicted cardiovascular complication risks in patients with type 2 diabetes

Clipper F. Young, PharmD, MPH, CDCES, BC-ADM, BCGP; Rachael Mullin, OMS IV; Joy A. Moverley, MPH, PA-C, DHSc; and Jay H. Shubrook, DO
Notes and Affiliations
Notes and Affiliations

Received: August 13, 2021

Accepted: January 14, 2022

Published: February 22, 2022

  • Clipper F. Young, PharmD, MPH, CDCES, BC-ADM, BCGP, 

    Primary Care Department, College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA

  • Rachael Mullin, OMS IV, 

    College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA

  • Joy A. Moverley, MPH, PA-C, DHSc, 

    College of Education and Health Sciences, Joint MSPAS/MPH Program, Touro University California, Vallejo, CA, USA

  • Jay H. Shubrook, DO, 

    Primary Care Department, College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA

Abstract

Context: Diabetes-related distress (DRD) is experienced by nearly 50% of people with diabetes at any given time in their diagnosis. The effects of low socioeconomic status (SES) and lacking access to resources can increase DRD. In addition, cardiovascular (CV) complications associated with diabetes are associated with higher DRD scores.

Objectives: This study evaluated the associations between DRD and predicted CV risks in participants with type 2 diabetes.

Methods: This cross-sectional study included 234 individuals with low SES who were Medi-Cal (California version of Medicaid) beneficiaries and sought medical care at a safety-net clinic system. The Problem Areas in Diabetes (PAID) questionnaire assessed DRD levels. The United Kingdom Prospective Diabetes Study Risk Engine was utilized to predict 10-year risks for coronary heart disease (CHD), fatal CHD, stroke, and fatal stroke. A multivariate linear regression model was constructed between the two variables, including other variables to control for potential confounding factors, for assessing the associations.

Results: After controlling for potential confounders, participants’ total PAID questionnaire scores were significantly associated with their 10-year predicted fatal CHD risks (B=0.060, 95% CI: [0.00084, 0.12], p=0.047).

Conclusions: After controlling for covariates, DRD levels exhibited a significant association with increased 10-year predicted fatal CHD risks in patients with type 2 diabetes and lower SES. Screening for DRD and provision of appropriate psychosocial interventions may reduce the risks of CHD in those with type 2 diabetes.

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