Lipids and psychosocial status in aboriginal persons with and at risk for Type 2 diabetes: implications for tertiary prevention

This study assessed psychosocial correlates of dyslipidemia, towards enabli ng improved tertiary prevention of macrovascular complications of diabetes mellitus (DM). We tested the hypothesis that psychosocial measures are rela ted to high-density lipoprotein cholesterol (HDL-C) and triglyceride concen trations in a rural aboriginal population in British Columbia, Canada. Pers ons sampled were on-reserve registered Indians (n = 198) with and at risk f or Type 2 DM. Relationships between HDL-C and psychosocial variables were a ssociated with glycemic status. For persons with diabetes and impaired gluc ose tolerance (n = 44), quality of life and mastery were positively related (P < 0.001), and depression inversely related (P < 0.001), to HDL-C. An ap parent lack of effect of behavior suggests the influence of emotional pathw ays involving autonomic-neuroendocrine axes. We recommend assessing mental health, and promoting mastery and diabetes quality of life through empowerm ent oriented diabetes management strategies, in negotiating culturally acce ptable treatment of diabetic dyslipidemia for aboriginal people. (C) 2001 E lsevier Science Ireland Ltd. All rights reserved.