The relationship of diabetes-related distress and depressive symptoms with physical activity and dietary behaviors in adults with type 2 diabetes: A cross-sectional study

J Diabetes Complications. 2016 Jul;30(5):967-70. doi: 10.1016/j.jdiacomp.2016.02.019. Epub 2016 Mar 3.

Abstract

Aims: Diabetes-related distress (DD) and depressive symptoms (DS) may influence self-management behaviors in people living with type 2 diabetes (T2D). We examined the association of DD and DS with physical activity (PA) and adherence to recommended dietary behaviors in adults with T2D.

Methods: Using baseline data from 2040 adults with T2D in the Alberta's Caring for Diabetes (ABCD) cohort study, DD, DS, PA and adherence to dietary behaviors were assessed. A composite variable for presence of DD and DS was computed for analyses. ANOVA and logistic regression tested independent associations of DS and DD with PA and adherence to diet.

Results: Participants were 64±10.6years, 45% female, 76% with annual household income≤$80,000, and 86% with high school education or more. Those with DD alone were 1.8 times (95% CI 1.1, 2.9) and those with DD and DS combined were 2.0 times (95% CI 1.1, 3.7) more likely not to meet PA guidelines compared to those without DD or DS. The presence of DS alone was not significantly associated with meeting PA guidelines (OR 1.4; 95% CI 0.7, 3.0). Compared to those without DD or DS, patients with DD alone (OR 1.5; 95% CI 1.4, 3.4), DS alone (OR 5.2; 95% CI 2.7, 9.7), or DD and DS combined (OR 2.5; 95% CI 1.6, 3.8) were more likely to have poor adherence to recommended dietary behaviors.

Conclusions: Greater distress or depressive symptoms were associated with worse self-management behaviors in adults with T2D. Attention to mental health status may improve participation in PA and adherence to diet recommendations in these patients.

Keywords: Depressive symptoms; Diabetes distress; Diet recommendations; Physical activity.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alberta
  • Cohort Studies
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / psychology
  • Cost of Illness
  • Cross-Sectional Studies
  • Depression / etiology*
  • Depression / psychology
  • Diabetes Mellitus, Type 2 / diet therapy
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / therapy
  • Diet, Diabetic / adverse effects*
  • Diet, Diabetic / psychology
  • Exercise* / psychology
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance* / psychology
  • Prospective Studies
  • Self Report
  • Self-Management* / psychology
  • Stress, Psychological / etiology*
  • Stress, Psychological / psychology

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