OBJECTIVE: Our study examined associations between serious psychological distress and blood glucose level (HbA1c) and body mass index (BMI) among American Indian and Alaska Native (AI/AN) participants in a cardiovascular disease prevention program. DESIGN: Using linear regression, we assessed the relationships between serious psychological distress and HbA1c and BMI at baseline and one year later. SETTING, PARTICIPANTS, AND INTERVENTION: AI/AN participants were aged 18 years, diagnosed with type 2 diabetes, and enrolled in the Special Diabetes Project for Indians Healthy Heart Project. MAIN OUTCOME MEASURES: Outcomes were percentage of HbA1c and BMI, measured at enrollment and first annual exam. Both outcomes were continuous measures in all analyses. RESULTS: Serious psychological distress was associated at baseline with increased HbA1c in the unadjusted and adjusted models (adjusted b = .17%, P < 0.01). Serious psychological distress also was associated at baseline with increased BMI (.635 kg/m2, P = .01) and at one year with increased BMI (0.174 kg/m2, P = .01) in the unadjusted model. After adjustment for demographic and health characteristics, these relationships were no longer significant. CONCLUSIONS: Cross-sectional baseline findings are consistent with existing literature. One-year findings suggest need for further inquiry into mediators of psychological distress and examination of additional diabetes-specific health outcomes. Additional years of observation may be needed to disentangle relationships between serious psychological distress and BMI.
OBJECTIVE: Our study examined associations between serious psychological distress and blood glucose level (HbA1c) and body mass index (BMI) among American Indian and Alaska Native (AI/AN) participants in a cardiovascular disease prevention program. DESIGN: Using linear regression, we assessed the relationships between serious psychological distress and HbA1c and BMI at baseline and one year later. SETTING, PARTICIPANTS, AND INTERVENTION: AI/AN participants were aged 18 years, diagnosed with type 2 diabetes, and enrolled in the Special Diabetes Project for Indians Healthy Heart Project. MAIN OUTCOME MEASURES: Outcomes were percentage of HbA1c and BMI, measured at enrollment and first annual exam. Both outcomes were continuous measures in all analyses. RESULTS: Serious psychological distress was associated at baseline with increased HbA1c in the unadjusted and adjusted models (adjusted b = .17%, P < 0.01). Serious psychological distress also was associated at baseline with increased BMI (.635 kg/m2, P = .01) and at one year with increased BMI (0.174 kg/m2, P = .01) in the unadjusted model. After adjustment for demographic and health characteristics, these relationships were no longer significant. CONCLUSIONS: Cross-sectional baseline findings are consistent with existing literature. One-year findings suggest need for further inquiry into mediators of psychological distress and examination of additional diabetes-specific health outcomes. Additional years of observation may be needed to disentangle relationships between serious psychological distress and BMI.
Authors: Ronald C Kessler; Peggy R Barker; Lisa J Colpe; Joan F Epstein; Joseph C Gfroerer; Eva Hiripi; Mary J Howes; Sharon-Lise T Normand; Ronald W Manderscheid; Ellen E Walters; Alan M Zaslavsky Journal: Arch Gen Psychiatry Date: 2003-02
Authors: W H Polonsky; B J Anderson; P A Lohrer; G Welch; A M Jacobson; J E Aponte; C E Schwartz Journal: Diabetes Care Date: 1995-06 Impact factor: 19.112
Authors: R C Kessler; G Andrews; L J Colpe; E Hiripi; D K Mroczek; S L T Normand; E E Walters; A M Zaslavsky Journal: Psychol Med Date: 2002-08 Impact factor: 7.723