Abstract
IntroductionAge-related medical conditions are increasing worldwide. Type 2 Diabetes mellitus (T2DM) represents a chronic disease, which affects a large amount of general population, accounting for over 90% of diabetes mellitus (DM) cases.PurposeAs psychopathological symptoms frequently occur in medical conditions, our study aimed at exploring whether psychological factors and metabolic control may affect health related quality of life (HRQoL).MethodsForty five patients with T2DM were consecutively recruited and assessed with a psychodiagnostic battery: Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory II edition (BDI-II) and the 36-Item Short Form Health Survey (SF-36), including indexes Physical and Mental Component Summary (PCS, MCS). Moreover, time since DM diagnosis and glycated hemoglobin (HbA1c) values were detected.ResultsParticipants (mean age 65.3 ± 5.9 years) had a mean time since diagnosis of 11.6 ± 6.7 years, and showed a good metabolic control as highlighted by mean HbA1c values 7.1 ± 0.9%. Median HAM-A score [25(20.7–30.6)], represented high prevalence of anxious symptoms. A moderate expression of depressive symptoms was observed [BDI-II score: 13(8.3–21.4)]. A multiple regression analysis, after correcting for age, BMI, HbA1c value and BDI-II score, showed the perceived quality of life relative to PCS was significantly related to both disease duration (β = −0.55, p = 0.03, SE = 0.25) and HAM-A scores (β = −0.52, p = 0.04, SE = 0.24). Moreover, both HAM-A (β = −0.67, p = 0.01, SE = 0.26) and BDI-II (β = −0.48, p = 0.02, SE = 0.20) scores were independently predictive of MCS. Metabolic control, instead, was not a significant predictor.ConclusionOur study suggests a predictive role of both anxiety levels and time since diagnosis in perceived HRQoL in T2DM patients. PCS was associated with anxiety and time since diagnosis and MCS was associated with anxiety and depressive symptoms but not with diabetes duration or metabolic control. These data could be useful to plan T2DM training programs focused on psychological health concerns, possibly leading to a healthy self-management and a better perceived HRQoL, even assisting patients in reducing the negative effect due to the chronicization of T2DM.
Highlights
Our hypothesis was that anxiety may negatively affect healthy related quality of life (HRQoL), with special regard to mental wellbeing, while diabetes duration and metabolic control may impact on physical well-being
We found that time since Type 2 Diabetes Mellitus (T2DM) diagnosis was strictly related to HRQoL; mainly time since diagnosis was negatively associated to physical functioning and Physical component summary (PCS) and individuals’ age was inversely related to both role physical and physical functioning
Our study suggests a predictive role of both anxiety levels and time since diagnosis in HRQoL in a chronic disease such as T2DM
Summary
Purpose: As psychopathological symptoms frequently occur in medical conditions, our study aimed at exploring whether psychological factors and metabolic control may affect health related quality of life (HRQoL). The debate about the association between psychopathological factors and chronic medical conditions is still open and there is an increasing interest on the specific role psychological determinant may have on chronic diseases and healthy related quality of life (HRQoL) (Trikkalinou et al, 2017). On the basis of previous studies which explored HRQoL in patients with T2DM (Hasan et al, 2016; Markle-Reid et al, 2018; Nguyen et al, 2018), the aim of our research was to further investigate the relationship between anxious and depressive symptoms, time since T2DM diagnosis and metabolic control on HRQoL, with specific regard to physical and mental component summaries. Our hypothesis was that anxiety may negatively affect HRQoL, with special regard to mental wellbeing, while diabetes duration and metabolic control may impact on physical well-being
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