SYMPTOMS AND WELL-BEING IN RELATION TO GLYCEMIC CONTROL IN TYPE-II DIABETES

OBJECTIVE - To describe the cross-sectional relation between glycemic control and physical symptoms, emotional well-being, and general well- being in patients with type II diabetes. RESEARCH DESIGN AND METHODS - The study population consisted of 188 patients with type II diabetes between 40 and 75 years of age. Patients were treated with blood gluco se-lowering agents or had either a fasting venous plasma glucose level greater than or equal to 7.8 mmol/l or an HbA(1)c level >6.1%. Multip le regression analyses were performed. Dependent variables were scores on the Type II Diabetes Symptom Checklist, the Profile of Mood Slates , the Affect Balance Scale, and questions regarding general well-being . The primary determinant under study was HbA(1c). In addition, age, s ex, neuroticism (indicating a general tendency to complain), insulin u se, and comorbidity were included as determinants in all analyses. Oth er potential determinants taken into consideration were hypoglycemic c omplaints, marital status, diabetes duration, cardiovascular history, blood pressure, BMI, waist-to-hip ratio, perceived burden of treatment , and smoking. None of these potential determinants had to be included to correct confounding of the relation between HbA(1c) and well-being scores. RESULTS - Higher HbA,, levels were significantly associated w ith higher symptom scores (total score, hyperglycemic score, and neuro pathic score), with worse mood (total score, displeasure score, depres sion, tension, fatigue), and with worse general well-being. The relati ve risks varied between 1.02 and 1.36 for each percentage difference i n HbA(1c). The relation between HbA(1c) and some mood states was modif ied by neuroticism: in the less neurotic patient (i.e,, one who is les s inclined to complain), the relation was more evident. CONCLUSIONS - These data suggest that better glycemic control in type II diabetes is associated with fewer physical symptoms, better mood, and better well -being, in a nonhypoglycemic HbA(1c) range.