title: Age differences in hopelessness and toe pain in persons with insulin-dependent and non-insulin-dependent diabetes mellitus.
abstract: BACKGROUND
  Several studies have established an association between diabetic neuropathy and depressive symptoms. There is a link between depression and peripheral neuropathy in diabetic patients, suggesting an increased likelihood that diabetic patients will experience depressive symptoms related to lower-extremity peripheral neuropathy and arthritis during middle age and later life. The goal of this investigation was to determine whether there are age differences between insulin-dependent and non-insulin-dependent diabetic patients regarding their feelings of hopelessness and toe pain.
  
  
  METHODS
  A large population-based sample of 32,006 adults from the 1998 National Health Interview Survey was analyzed with multivariate statistical procedures. We performed χ² and correlation procedures to test the null hypothesis that there are no age or sex differences between insulin-dependent and non-insulin-dependent diabetic patients in their reporting of feelings of hopelessness and toe pain symptoms in the previous 12 months.
  
  
  RESULTS
  There were significant differences between age and sex groups of insulin-dependent and non-insulin-dependent diabetic patients in reporting feelings of hopelessness and toe pain symptoms, rejecting the null hypothesis. Correlational analysis conducted between the variables of hopelessness and toe pain yielded significant correlations in insulin-dependent (r = .28; P = .0009; α = .05), and non-insulin-dependent (r = 0.19; P = .001; α = .05) women older than 61 years, concluding that diabetic women are more likely to experience hopelessness and toe pain in that age group regardless of insulin status.
  
  
  CONCLUSIONS
  Clinicians should incorporate depression and toe pain symptoms into their assessment and treatment, especially in diabetic women older than 61 years.
authors.affiliation: Department of Nursing and Health Sciences, California State University, East Bay, Oakland, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Morewitz
authors.forename: Najwa
authors.initials: N
authors.lastname: Javed
authors.forename: Sharada
authors.initials: S
authors.lastname: Tata
authors.forename: Joel
authors.initials: J
authors.lastname: Clark
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology*; D003929:Diabetic Neuropathies / Q000453:epidemiology* / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult