Diabetes distress, depressive, and anxiety symptoms in people with type 2 diabetes: a network analysis approach to understanding comorbidity

Article

McInerney, A., Lindekilde, N., Nouwen, A., Schmitz, N. and Deschenes, S. 2022. Diabetes distress, depressive, and anxiety symptoms in people with type 2 diabetes: a network analysis approach to understanding comorbidity. Diabetes Care. 45 (8), pp. 1715-1723. https://doi.org/10.2337/dc21-2297
TypeArticle
TitleDiabetes distress, depressive, and anxiety symptoms in people with type 2 diabetes: a network analysis approach to understanding comorbidity
AuthorsMcInerney, A., Lindekilde, N., Nouwen, A., Schmitz, N. and Deschenes, S.
Abstract

Objective
This study aimed to explore interactions between diabetes distress, depressive, and anxiety symptoms in a cohort of adults with type 2 diabetes using network analysis.
Research design and methods
Participants (N = 1,796) were from the Evaluation of Diabetes Insulin Treatment (EDIT) study from Quebec, Canada. A network of diabetes distress symptoms was estimated using the 17 items of the Diabetes Distress Scale (DDS-17). A second network was estimated using the 17 items of the DDS-17, the 9 depressive items of the Patient Health Questionnaire (PHQ-9), and the 7 anxiety items of the Generalized Anxiety Disorder Assessment (GAD-7). Network analysis was used to identify central symptoms, clusters of symptoms, and symptoms that may bridge between diabetes distress, depressive, and anxiety symptoms.
Results
Regimen-related and physician-related diabetes distress symptoms were amongst the most influential (most positive connections to others) in the diabetes distress network. Feeling like a failure (depression) was identified as a potential bridge between depression and diabetes distress, being highly connected to symptoms of diabetes distress. The anxiety symptoms of worrying too much and being unable to stop worrying were found to be bridge symptoms between both anxiety and depression symptoms, and anxiety and diabetes distress symptoms, respectively.
Conclusions
These findings suggest individual symptoms that might be influential to the development and maintenance of diabetes distress and mental health comorbidity in diabetes and warrant further investigation. Study limitations and potential for clinical applicability are discussed.

Keywordsanxiety; comorbidity; depressive disorders; diabetes mellitus; type 2; mental health
PublisherAmerican Diabetes Association
JournalDiabetes Care
ISSN0149-5992
Electronic1935-5548
Publication dates
Online26 Jul 2022
PrintAug 2022
Publication process dates
Deposited19 May 2022
Accepted17 Apr 2022
Submitted05 Nov 2021
Output statusPublished
Accepted author manuscript
Copyright Statement

This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes Care on April 17 2022. The American Diabetes Association (ADA), publisher of Diabetes Care, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version is available in in Diabetes Care 2022;45(8):1715–1723 online at https://doi.org/10.2337/dc21-2297

Additional information

This article contains supplementary material online at https://doi.org/10.2337/figshare.19692721

Digital Object Identifier (DOI)https://doi.org/10.2337/dc21-2297
PubMed ID35704532
Web of Science identifierWOS:000843954800007
Related Output
Is supplemented byhttps://doi.org/10.2337/figshare.19692721
LanguageEnglish
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