Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors

Singh, RP; Teel, Cynthia; Sabus, Carla; McGinnis, Patricia; Kluding, Patricia M.

doi:10.1371/journal.pone.0165652

Cited by 67 publications

(85 citation statements)

References 72 publications

(58 reference statements)

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“…Indeed, fatigue is known to be prevalent in persons with type 1 and type 2 diabetes. [23][24][25] Fatigue was most pronounced in patients with lower well-being status. Persons with low mood score around 33 points (on a 0-100 scale) higher compared with persons with normal well-being, while those likely depressed score approximately 46 points as higher relative to normal well-being.…”

Section: Discussionmentioning

confidence: 99%

Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics

Wieringa

Twisk

Snoek

2020

BMJ Open Diab Res Care

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IntroductionThe Diabetes Symptom Checklist-Revised (DSC-R) is a well-validated patient-reported outcome designed to assess symptom burden in persons with type 2 diabetes mellitus (T2DM) across eight domains. The DSC-R has so far primarily been used in research settings. With the aim to make the DSC-R applicable in clinical practice by improving its interpretability, we sought to identify patient characteristics associated with DSC-R (domain) scores as a first initiative toward reference values.Research design and methodsWe used baseline data from two large observational studies to select patient characteristics significantly associated with DSC-R domain and total scores. Multivariable Tobit analyses with the backward procedure per (domain) score were performed.ResultsData from 1531 participants with T2DM were included. On a 0–100 scale, the median DSC-R total score was 15.88 (7.06–29.41), with domain scores ranging from 5.00 (0.00–22.50) (pain) to 35.00 (10.00–60.00) (fatigue). Low well-being status was most profoundly associated with higher scores across all domains. Persons with one or more complication, as well as one or more symptomatic hypoglycemic episode during the past 3 months, scored higher on (almost) all domains and the total scale.ConclusionsComplications, symptomatic hypoglycemia, and low well-being are important characteristics to take into account when using the DSC-R in individual patients. Further validation of our findings is warranted in diverse patient populations.

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Section: Discussionmentioning

confidence: 99%

Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics

Wieringa

Twisk

Snoek

2020

BMJ Open Diab Res Care

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“…However, a cross-sectional study of people with T2DM showed that depression symptoms were not a predictor of fatigue severity in this population. Rather, sleep quality was found to be the strongest explanatory factor for fatigue [32]. One possible explanation for this inconsistency may be the use of a validated survey for insomnia in the former studies versus screening for sleep disturbances using a subjective sleep quality questionnaire in the latter.…”

Section: Discussionmentioning

confidence: 98%

Daytime Functioning in People with Type 2 Diabetes and Insomnia Symptoms: A Comparison-Correlational Study

Alshehri¹,

Rucker²,

Alenazi³

et al. 2020

Preprint

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Background Sleep disturbances showed negative impact on self-care and diabetes outcomes for people with type 2 diabetes. However, there is a need to understand to what extent insomnia symptoms impact daytime functioning in people with type 2 diabetes. This study compared common daytime functioning outcomes including fatigue, daytime sleepiness, and quality of life related to vitality and physical function in people with type 2 diabetes with and without insomnia symptoms. Methods This study was a cross-sectional comparison design which used validated instruments to assess common daytime functioning outcomes (i.e. fatigue severity scale, daytime sleepiness, and quality of life related to vitality and physical function domains) in 60 participants with type 2 diabetes with and without symptoms of insomnia. Insomnia Severity Index was used to stratify participants into an insomnia group and non-insomnia control group. Multivariate linear model and partial correlations tests were utilized to examine the relationships between outcomes in the two groups after controlling for age and depression symptoms. Results Levels of fatigue severity, and quality of life related vitality and physical function were worse in the insomnia group compared to non-insomnia group (P<.004). After controlling for age, the multivariate linear model showed that the insomnia group had greater fatigue severity (R 2 =0.15, p=.003), and lower quality of life related to vitality and physical function (R 2 =0.25, p<.001; and R 2 =0.11, p=.004, respectively). Partial correlation showed that daytime sleepiness was correlated with Insomnia Severity Index in the full sample after controlling for age ( r =.35, p =.006). When added depression symptoms into the models, the differences or relationships were not observed. Conclusion Fatigue, and quality of life related vitality and physical function were worse in people with both type 2 diabetes and insomnia symptoms compared to people with type 2 diabetes only. Depression symptoms may have an independent contribution for the daytime functioning.

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“…It is a serious public health problem all over the world. Apart from the most widely known microvascular and macrovascular complications associated with diabetes, comorbidities such as fatigue, depression, and sleep disturbances affect the quality of life and the compliance to treatments of patients with diabetes (1,2). Fatigue is a common symptom in the general population that is known to be associated with different etiologies, negatively affecting both physical and mental capacity.…”

Section: Introductionmentioning

confidence: 99%

“…The literature studies concerning patients affected with type 1 (T1D) and 2 (T2D) diabetes mellitus suggest the duration of diabetes mellitus, glycemic control, the frequency and severity of hypoglycemic attacks, depression, sleep problems, microvascular complications, pain, and body mass indices are the major predisposing factors for developing fatigue (2,6,7). Fatigue is also known to impair the compliance of treatment and disturb the glycemic control of patients with diabetes (1,2). Depression is frequent comorbidity associated with diabetes, as recent studies documented that depression affects up to 25% of patients and the risk of major depression is doubled in patients with T2D (8).…”

Section: Introductionmentioning

confidence: 99%

Fatigue is Related to Insulin Use by Acting Via Depressive Mood in Patients with Diabetes Mellitus

Haliloğlu¹,

Tutuncu²,

Şahin³

et al. 2020

Turk J Endocrinol Metab

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Objective: Fatigue is a common symptom in diabetes mellitus. The aim of this study was to determine the factors leading to fatigue and to investigate the effect of insulin use on fatigue among the diabetic population. Material and Methods: Onehundred diabetic patients attending the diabetes clinic of Cerrahpasa Medical Faculty between October 2017-January 2018 and 42 healthy controls were evaluated in this cross-sectional study. Questionnaires including demographic and disease characteristics, Fatigue Impact Scale (FIS), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), quality of life scale (SF-36), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI) were used. Results: Ages (47.6±14.8 and 45.7±14.1 years; p=0.47) and body mass indices (26.6±4.1 and 25.3±3.5 kg/m 2 ; p=0.08) of 100 patients with diabetes (Type 1 Diabetes/Type 2 Diabetes= 29/71) and 42 healthy volunteers were similar. The diabetic group had worse FIS total (p=0.05), FIS psychological (p=0.04) scores and SF-36 scores compared to the healthy controls. When the patients with diabetes were divided into two groups according to insulin use and compared with healthy controls, the ESS and PSQI were similar but all FIS parameters (total p=0.005, cognitive p=0.007, physical p=0.01, psychological p=0.009) and BDI (p=0.05) were significantly worse in patients with insulin use than non-insulin and control groups. The relationship between fatigue and insulin use was independent of glycemic control and duration of diabetes but was affected by the BDI (p=0.001). Conclusion: Insulin use leads to fatigue in patients with diabetes, regardless of diabetes type, and this effect is influenced by depressive mood. Psychotherapeutic approaches prior to insulin treatment might yield fruitful results.

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Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors

Cited by 67 publications

References 72 publications

Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics

Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics

Daytime Functioning in People with Type 2 Diabetes and Insomnia Symptoms: A Comparison-Correlational Study

Fatigue is Related to Insulin Use by Acting Via Depressive Mood in Patients with Diabetes Mellitus

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