Diverse forms of distress have distinct impact in diabetes

(HealthDay)—In primary care patients with type 2 diabetes, depressive symptoms (DS) are predictive of future lifestyle-oriented self-management behaviors, while diabetes-related distress (DRD) predicts glycemic control, possibly due to medication adherence, according to research published online Oct. 1 in Diabetes Care.

James E. Aikens, Ph.D., from the University of Michigan in Ann Arbor, conducted a longitudinal, six-month study involving 253 primary care patients with type 2 diabetes to compare DS and DRD as longitudinal predictors of medication adherence, self-care behavior, and glycemic control.

Aikens found that the results were similar with cross-sectional and longitudinal analyses. In longitudinal analyses, DS alone correlated significantly with future diet behavior, physical activity and glucose testing. DRD alone was a significant predictor of future glycemic control and medication adherence.

"This study provides longitudinal support for the conceptual and empirical distinctions between DS and DRD in type 2 diabetes. DS may selectively suppress lifestyle-oriented self-management behaviors such as healthy eating, glucose testing, and exercise," Aikens concludes. "In contrast, diabetes-specific distress may impact subsequent medication adherence and glycemic control. Clinical assessment and intervention should encompass both factors."