Does emotional distress predict worse glycemic control over time? Results from the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study

• DOI: 10.2337/figshare.24294964
• Publication Date: 2024-01-22T20:14:30Z
• Authors: Andrea L Cherrington; Ionut Bebu; Heidi Krause-Stei...; Claire J. Hoogend...; Gladys Crespo-Ramos; Caroline Presley; Aanand D. Naik; Ashok Balasubrama...; Michaela R Gramzi...; Tina Killean; Valerie L Arends; Jeffrey S. Gonzalez
• Keywords: Male; Blood Glucose; Glycated Hemoglobin; Comparative Effectiveness Research; Glycemic Control; Middle Aged; Psychological Distress; 03 medical and health sciences; 0302 clinical medicine; Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Female

<p dir="ltr">Objectives To evaluate whether baseline levels of depressive symptoms and diabetes specific distress are associated with glycemic control in the GRADE study, a large randomized controlled trial comparing the metabolic effects of four common glucose-lowering medications when combined with metformin in individuals with type 2 diabetes.</p><p dir="ltr">Methods The primary and secondary outcomes were defined as an HbA1c value ≥7%, subsequently confirmed, and an HbA1c value ˃7.5%, subsequently confirmed, respectively. Separate Cox proportional hazards models assessed the association between baseline levels of each exposure of interest (depressive symptoms measured by Patient Health Questionnaire (PHQ-8) and diabetes distress measured by Diabetes Distress Scale) and the subsequent risk of metabolic outcome. </p><p dir="ltr">Results This substudy included 1,739 participants (56% Non-Hispanic White, 18% Non-Hispanic Black, 17% Hispanic, 68% male, mean [SD] age=58.0 [10.2] years, diabetes duration=4.2 [2.8] years, and HbA1c=7.5% [0.48]). A total of 1,157 participants reached the primary outcome, with time to event of 2.1 years on average, while 738 participants reached the secondary outcome at 3 years on average. Adjusting for sex, race/ethnicity, treatment group, and baseline age, duration of type 2 diabetes, body mass index, and HbA1c, there were no significant associations between the depressive symptoms or diabetes distress and the subsequent risk of the primary or secondary outcomes. </p><p dir="ltr">Conclusions The current findings suggest that, at least at for individuals with diabetes of relatively short duration, baseline levels of emotional distress are not associated with glycemic control over time.</p>