Lifestyle and emotional well-being in men and women with type 2 diabetes (e-VitaDM-4; ZODIAC-48).
BACKGROUND
Whether lifestyle is associated with well-being in patients with type 2 diabetes (T2D) is largely unknown. Uncovering and clarifying associations between these constructs may lead to new strategies for improving both.


OBJECTIVE
The aim was to investigate the relationship between lifestyle and well-being, focussing on gender differences.


METHODS
This cross-sectional study included 1085 patients with T2D that participated in the e-Vita part of the Zwolle outpatient diabetes project integrating available care (ZODIAC) study. Patients were included from May 2012 until September 2014 from 52 general practices. Emotional well-being was assessed with the World Health Organization-5 well-being index (WHO-5). Lifestyle information on body mass index, smoking, physical activity and alcohol use was extracted from self-reported questionnaires. Multiple linear regression analyses were used.


RESULTS
After adjustment for other lifestyle factors, physical activity, smoking and drinking 22-35 alcohol consumptions per week were associated with the WHO-5 score in men and physical activity and smoking were associated with the WHO-5 score in women. In the fully adjusted analyses for the total study population, physical activity and smoking were still associated with the WHO-5 score (b = 1.1, P < .001 and b =-3.1, P = .018, respectively). In the fully adjusted analyses stratified to gender only physical activity was associated with the WHO-5 score (in men: b =0.8, P = .006, in women: b = 1.4, P = .001).


CONCLUSIONS
This study shows a negative, non-clinically relevant association between smoking and emotional well-being in the total population with T2D and a positive, non-clinically relevant association between physical activity and emotional well-being in both men and women with T2D.
a Diabetes Centre , Isala, Zwolle , The Netherlands.
Steven H
SH
Hendriks
a Diabetes Centre , Isala, Zwolle , The Netherlands.|b Department of General Practice , University of Groningen and University Medical Centre Groningen , Groningen , The Netherlands.
Evelien G W
EG
van Soldt
c Department of Medical Psychology , VU University Medical Centre , Amsterdam , The Netherlands.
Michael
M
van Vugt
a Diabetes Centre , Isala, Zwolle , The Netherlands.|b Department of General Practice , University of Groningen and University Medical Centre Groningen , Groningen , The Netherlands.
Klaas H
KH
Groenier
a Diabetes Centre , Isala, Zwolle , The Netherlands.
Yvonne
Y
Roelofsen
d Department of Cardiology , Radboud University Medical Centre , Nijmegen , The Netherlands.
Angela H E M
AH
Maas
a Diabetes Centre , Isala, Zwolle , The Netherlands.|e Department of Internal Medicine , University of Groningen and University Medical Centre Groningen , Groningen , The Netherlands.|f Department of Internal Medicine , Isala , Zwolle , The Netherlands.
Henk J G
HJ
Bilo
e Department of Internal Medicine , University of Groningen and University Medical Centre Groningen , Groningen , The Netherlands.|g Medical Research Group Langerhans , Zwolle , The Netherlands.
Nanne
N
Kleefstra
g Medical Research Group Langerhans , Zwolle , The Netherlands.
Kornelis J J
KJ
van Hateren
D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D004644:Emotions; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires
Diabetes; emotional well-being; gender; lifestyle factors