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Are psychopathological features relevant predictors of glucose control in patients with type 2 diabetes? A prospective study

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Abstract

Type 2 diabetes has been associated with an increased prevalence of psychopathology, in comparison with matched non-diabetic controls. However, the cross-sectional design of most studies does not allow causal inferences. The aim of the present study is the exploration of this possible association in patients with type 2 diabetes, in a longitudinal fashion. This prospective observational study was conducted on a consecutive series of 250 type 2 diabetic outpatients and a 1-year follow-up period was performed. At enrollment, a complete medical history was collected and hemoglobin A1c was measured. General psychopathology was assessed using the Symptom Checklist 90-revised and the Eating Disorder Examination Questionnaire. Among the 187 patients available at follow-up, factors associated with unsatisfactory glycemic control at follow-up were baseline hemoglobin A1c, insulin therapy, a longer duration of diabetes, higher scores on the Eating behavior, and Somatization scales. At multivariate analysis, the attainment of hemoglobin A1c ≤7 % was associated with baseline hemoglobin A1c (p = 0.01), insulin therapy (p = 0.016), and Eating behavior (p = 0.02), whereas duration of diabetes and Somatization were no longer significant after adjusting for confounders. The results of the present study suggest that clinical features have a much greater impact on attainment of therapeutic goals than psychopathology. However, there are several aspects, such as temperament, motivation, self-efficacy, and well-being, not assessed in the present study, which could be crucial. These areas should be adequately explored for obtaining an overall picture of the psychological determinants of appropriate metabolic control in diabetes.

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Authors and Affiliations

  1. Diabetes Agency, Careggi Teaching Hospital and University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Francesco Rotella & Edoardo Mannucci

  2. Section of Endocrinology, Careggi Teaching Hospital and University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Barbara Cresci, Valentina Aletti & Ilaria Dicembrini

  3. Geriatric Medicine and Cardiology, Careggi Teaching Hospital and University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Matteo Monami & Maria Luisa Ambrosio

  4. Psychiatric Unit, Careggi Teaching Hospital and University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Vanna Andreoli & Valdo Ricca

Authors
  1. Francesco Rotella
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  2. Barbara Cresci
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  3. Matteo Monami
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  4. Valentina Aletti
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  5. Vanna Andreoli
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  6. Maria Luisa Ambrosio
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  7. Valdo Ricca
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  8. Ilaria Dicembrini
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  9. Edoardo Mannucci
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Correspondence to Francesco Rotella.

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Rotella, F., Cresci, B., Monami, M. et al. Are psychopathological features relevant predictors of glucose control in patients with type 2 diabetes? A prospective study. Acta Diabetol 49 (Suppl 1), 179–184 (2012). https://doi.org/10.1007/s00592-012-0403-4

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  • DOI: https://doi.org/10.1007/s00592-012-0403-4

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