title: Gender differences in the association between lifestyle behaviors and diabetes distress in a community sample of adults with type 2 diabetes.
abstract: BACKGROUND
  The present study examined the association between moderate and severe diabetes distress (DD) and lifestyle behaviors (physical activity, smoking, alcohol consumption) in a community sample of adults with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  A total of 1971 adults with T2DM were recruited using mixed methods sampling. Participants were considered eligible if they had a doctor diagnosis of T2DM (≤10 years), were insulin naïve, aged 40-75 years, and were from Quebec, Canada. Participants provided information on DD, lifestyle behaviors, sociodemographic, and diabetes-related factors. Multinomial logistic regressions examined the association between moderate and severe DD and each lifestyle behavior, according to gender. Effect estimates can be interpreted as probability ratios (PR).
  
  
  RESULTS
  In females, physical inactivity was associated with an increased likelihood of moderate distress (PR 2.2; 95% confidence interval [CI] 1.49-3.24) and severe distress (PR 1.80; 95% CI 1.00-3.24). In males, only severe distress was associated with physical inactivity (PR 1.92; 95% CI 1.00-3.66). Current smoking was associated with a greater probability of severe distress in males (PR 3.0; 95% CI 1.54-5.84) and females (PR 1.32; 95% CI 0.67-2.60); however this effect was stronger in males. No association was found between alcohol consumption and DD in females. In males, frequent alcohol consumption was associated with a reduced probability of moderate (PR 0.56; 95% CI 0.34-0.91) and severe distress (PR 0.47; 95% CI 0.21-1.06).
  
  
  CONCLUSIONS
  The findings of this study suggest important gender differences in the association between DD and lifestyle behaviors.
authors: Department of Epidemiology and Biostatistics, Montreal, Quebec, Canada.|Douglas Mental Health University Institute, Montreal, Quebec, Canada.
authors: Carla
authors: C
authors: Lipscombe
authors: Department of Life Sciences.|Institute of Environment Health and Societies, Healthy Ageing, Brunel University, Uxbridge, UK.
authors: Kimberley J
authors: KJ
authors: Smith
authors: Department of Epidemiology and Biostatistics, Montreal, Quebec, Canada.|Douglas Mental Health University Institute, Montreal, Quebec, Canada.
authors: Geneviève
authors: G
authors: Gariepy
authors: Department of Epidemiology and Biostatistics, Montreal, Quebec, Canada.|Department of Psychiatry, McGill University, Montreal, Quebec, Canada.|Douglas Mental Health University Institute, Montreal, Quebec, Canada.|Montréal Diabetes Research Centre, Montreal, Quebec, Canada.
authors: Norbert
authors: N
authors: Schmitz
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015444:Exercise; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011792:Quebec / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking; D013315:Stress, Psychological / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology
keywords: 2型糖尿病; alcohol drinking; exercise; mental health; smoking; type 2 diabetes mellitus; 吸烟; 心理健康; 锻炼; 饮酒