Alexandra A García1, Eliezer Bose2, Julie A Zuñiga2, Wenhui Zhang2. 1. The University of Texas at Austin School of Nursing, Austin, TX, United States of America; The University of Texas at Austin Dell Medical School, Austin, TX, United States of America. Electronic address: agarcia@mail.nur.utexas.edu. 2. The University of Texas at Austin School of Nursing, Austin, TX, United States of America.
Abstract
AIMS: Type 2 diabetes mellitus (T2DM), serious and increasingly prevalent among Mexican Americans, produces symptoms related to high and low glucose levels, medication side effects, and long-term complications. This secondary analysis explored symptom prevalence, differences among symptom burden levels, and how symptoms clustered. METHODS: Clinical measurements and survey data (demographic, quality of life, and the symptom subscale of the Diabetes Symptom Self-Management Inventory) collected from Mexican American adults with T2DM (n = 71) were analyzed for symptom prevalence, differences across levels of symptom burden, and symptom clusters. Agglomerative hierarchical and k-means clustering analyses were performed on a Gower matrix. Internal validation methods and rank aggregation were used to identify the best clustering method of the two techniques and to identify symptoms that clustered together. RESULTS: Participants reported mean = 14 symptoms; tiredness and trouble sleeping were most prevalent. People with high symptom burden had significantly lower quality of life and perceptions of worse diabetes severity. Hierarchical clustering produced three symptom clusters: cluster 1 = 9 symptoms (e.g. intense thirstiness, dry mouth); cluster 2 = 9 symptoms (e.g., itching skin, weight gain, noise or light sensitivity); cluster 3 = 13 symptoms (e.g., nervous, headache, trouble concentrating, and memory loss). CONCLUSION: Mexican Americans with T2DM report several co-occurring symptoms. Quality of life is significantly worse for people with high symptom burden. Three distinct symptom clusters were identified. Studies with larger samples are needed to further diabetes symptom science. Clinicians should assess and address patients' co-occurring symptoms as a potential means of decreasing symptom burden and improving quality of life.
AIMS: Type 2 diabetes mellitus (T2DM), serious and increasingly prevalent among Mexican Americans, produces symptoms related to high and low glucose levels, medication side effects, and long-term complications. This secondary analysis explored symptom prevalence, differences among symptom burden levels, and how symptoms clustered. METHODS: Clinical measurements and survey data (demographic, quality of life, and the symptom subscale of the Diabetes Symptom Self-Management Inventory) collected from Mexican American adults with T2DM (n = 71) were analyzed for symptom prevalence, differences across levels of symptom burden, and symptom clusters. Agglomerative hierarchical and k-means clustering analyses were performed on a Gower matrix. Internal validation methods and rank aggregation were used to identify the best clustering method of the two techniques and to identify symptoms that clustered together. RESULTS:Participants reported mean = 14 symptoms; tiredness and trouble sleeping were most prevalent. People with high symptom burden had significantly lower quality of life and perceptions of worse diabetes severity. Hierarchical clustering produced three symptom clusters: cluster 1 = 9 symptoms (e.g. intense thirstiness, dry mouth); cluster 2 = 9 symptoms (e.g., itching skin, weight gain, noise or light sensitivity); cluster 3 = 13 symptoms (e.g., nervous, headache, trouble concentrating, and memory loss). CONCLUSION: Mexican Americans with T2DM report several co-occurring symptoms. Quality of life is significantly worse for people with high symptom burden. Three distinct symptom clusters were identified. Studies with larger samples are needed to further diabetes symptom science. Clinicians should assess and address patients' co-occurring symptoms as a potential means of decreasing symptom burden and improving quality of life.
Authors: Jean C McSweeney; Mario A Cleves; Weizhi Zhao; Leanne L Lefler; Shengping Yang Journal: J Cardiovasc Nurs Date: 2010 Jul-Aug Impact factor: 2.083
Authors: David Fishbain; Jin Run Gao; John Lewis; Daniel Bruns; Laura J Meyer; John M Disorbio Journal: Pain Physician Date: 2014 May-Jun Impact factor: 4.965
Authors: Eliezer L Bose; Gilles Clermont; Lujie Chen; Artur W Dubrawski; Dianxu Ren; Leslie A Hoffman; Michael R Pinsky; Marilyn Hravnak Journal: J Clin Monit Comput Date: 2017-02-22 Impact factor: 2.502
Authors: Andrea M Barsevick; Kyra Whitmer; Lillian M Nail; Susan L Beck; William N Dudley Journal: J Pain Symptom Manage Date: 2006-01 Impact factor: 3.612
Authors: Aurélie Van Lancker; Dimitri Beeckman; Sofie Verhaeghe; Nele Van Den Noortgate; Ann Van Hecke Journal: Int J Nurs Stud Date: 2016-05-31 Impact factor: 5.837
Authors: Julie Ann Zuniga; Eliezer Bose; Jungmin Park; M Danet Lapiz-Bluhm; Alexandra A García Journal: J Assoc Nurses AIDS Care Date: 2017-07-15 Impact factor: 1.354