Exploring trajectories of diabetes distress in adults with type 2 diabetes; a latent class growth modeling approach

• Published in: Journal of affective disorders 2015-12, Vol.188, p.160-166
• Main Authors: Lipscombe, Carla, Burns, Rachel J, Schmitz, Norbert
• Format: Article
• Language: English
• Subjects: Adult; Aged; Canada - epidemiology; Comorbidity; Diabetes distress; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - psychology; Female; Humans; Longitudinal Studies; Male; Mental health; Middle Aged; Models, Psychological; Psychiatry; Psychological comorbidities; Stress, Psychological - diagnosis; Stress, Psychological - epidemiology; Surveys and Questionnaires; Type 2 diabetes
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2015.08.003

Abstract Background Moderate to severe diabetes distress (DD) is a common comorbidity among adults with type 2 diabetes. Cross-sectional studies find DD is strongly correlated with poor diabetes management, however little is known about the pattern of change of DD symptoms over long periods of time. We sought to identify and describe a set of distinct longitudinal trajectories of DD over 4 years of follow-up time. Methods We used data derived from the Evaluation of Diabetes Treatment study (2011–2014), a longitudinal community-based survey of Canadian adults (40–75 years) with type 2 diabetes ( n =1135). To determine the number and shape of trajectories, we used a latent class growth modeling approach. Results Five distinct trajectories of DD were identified. Trajectories 1 and 2 comprised participants with persistently low (61%) or persistently low, but at risk (22%) levels of distress. Trajectory 3 (7.5%) included participants with decreasing moderate levels of distress. Trajectory 4 (6.5%) consisted of participants with increasing moderate levels of distress. Trajectory 5 (2.4%) included participants with persistently severe levels of distress. Limitations Different populations may produce different DD trajectories and thus the generalizability of the strata identified in this report remains to be investigated. Future research is needed to determine the extent to which time-varying covariates might alter the path of DD trajectories. Conclusions For most individuals, DD is a fairly stable condition over 4 years of follow-up time. However, for a subset of individuals, DD symptoms worsened over time. Medical health professionals might consider repeated screenings for DD in adults with type 2 diabetes.