Emotional Distress and Cardiovascular Disease Risk Among Participants Enrolled in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study

Authors

Gladys Crespo-Ramos
Ionut Bebu
Heidi Krause-Steinrauf
Claire J Hoogendoorn
Ran Fang
Dominic Ehrmann
Caroline Presley
Aanand D Naik
Aimee Katona
Elizabeth A Walker
Andrea Cherrington
Jeffrey S Gonzalez

Publication Date

9-1-2023

Journal

Diabetes Research and Clinical Practice

Abstract

AIMS: People with type 2 diabetes (T2DM) have an increased risk of cardiovascular disease (CVD). We examined depressive symptoms (DS) and diabetes distress (DD) in relation to the estimated 10-year risk of CVD in adults with T2DM enrolled in the GRADE Emotional Distress Substudy.

METHODS: Linear regression models examined the associations of baseline DS and DD with estimated 10-year risk of CVD using the Atherosclerotic Cardiovascular Disease (ASCVD) risk score, adjusting for age, sex, race/ethnicity, education, income, diabetes duration, diabetes-related complications, and HbA1c.

RESULTS: A total of 1,605 GRADE participants were included: 54% Non-Latino (NL) White, 18% Latino, 19% NL-Black, 66% male, mean age 57.5 (SD = 10.25) years, diabetes duration 4.2 (SD = 2.8) years, and HbA1c 7.5% (SD = 0.5%). After incorporating covariates, only DS, especially cognitive-affective symptoms, were associated with ASCVD risk (estimate = 0.15 [95% CI: 0.04, 0.025], p = 0.006). Higher DS remained significantly associated with higher ASCVD risk when adding DD to covariates (estimate = 0.19 [95% CI: 0.07, 0.30], p = 0.002). DD was not associated with ASCVD risk when accounting for covariates.

CONCLUSIONS: Depressive symptoms, particularly cognitive-affective symptoms, are associated with increased 10-year predicted ASCVD risk among adults with early T2DM. Diabetes distress is not significantly associated with the predicted ASCVD risk when accounting for covariates.

Keywords

Adult, Humans, Male, Middle Aged, Female, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Glycated Hemoglobin, Risk Factors, Atherosclerosis, Psychological Distress, type 2 diabetes, cardiovascular complications, depression, diabetes-related distress

DOI

10.1016/j.diabres.2023.110808

PMID

37394014

PMCID

PMC10592312

PubMedCentral® Posted Date

9-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes