title: Diabetes-related symptom distress in association with glucose metabolism and comorbidity: the Hoorn Study.
abstract: OBJECTIVE
  The purpose of this study was to determine the associations between diabetes-related symptom distress, glucose metabolism status, and comorbidities of type 2 diabetes.
  
  
  METHODS
  This was a cross-sectional sample of 281 individuals with normal glucose metabolism (NGM), 181 individuals with impaired glucose metabolism (IGM), and 107 subjects with type 2 diabetes. We used the revised type 2 Diabetes Symptom Checklist (DSC-R) to assess diabetes-related symptom distress.
  
  
  RESULTS
  The total symptom distress score (range 0-100) was relatively low for diabetic subjects (mean +/- SD 8.4 +/- 9.4), although it was significantly different from that for subjects with IGM (6.5 +/- 7.1) and NGM (6.1 +/- 7.9) (F = 3.1, 2 d.f., P = 0.046). Ischemic heart disease was associated with elevated DSC-R scores on three subscales, whereas depression showed higher symptom distress levels across all DSC-R domains.
  
  
  CONCLUSIONS
  Worsening glucose metabolism is associated with increasing diabetes-related symptom distress. This relationship is attenuated by ischemic heart disease and particularly by depression.
authors: Institute of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands. marcel.adriaanse@falw.vu.nl
authors: Marcel C
authors: MC
authors: Adriaanse
authors: Frans
authors: F
authors: Pouwer
authors: Jacqueline M
authors: JM
authors: Dekker
authors: Giel
authors: G
authors: Nijpels
authors: Coen D
authors: CD
authors: Stehouwer
authors: Robert J
authors: RJ
authors: Heine
authors: Frank J
authors: FJ
authors: Snoek
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance / Q000453:epidemiology / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*
chemical_list: D005947:Glucose