Lower verbal intelligence is associated with diabetic complications and slower walking speed in people with Type 2 diabetes: the Maastricht Study

Spauwen, Peggy; Martens, Remy J H; Stehouwer, Coen D. A.; Verhey, Frans R.J.; Schram, Miranda T.; Sep, Simone J. S.; Kallen, Carla; Dagnelie, Pieter C.; Henry, Ronald M.A.; Schaper, Nicolaas C.; Boxtel, M.P.J. van

doi:10.1111/dme.13105

Cited by 9 publications

(9 citation statements)

References 28 publications

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“…A possible link between IQ and CP was also supported by Spauwen et al (2016) who found that lower verbal IQ was associated with the development of neuropathic pain in patients with diabetes. Our results are in agreement with this idea as they show a relationship between IQ and number line performance for pain patients, and in addition show no relationship in healthy controls.…”

Section: Discussionmentioning

confidence: 81%

The Influence of Chronic Pain and Cognitive Function on Spatial-Numerical Processing

Spindler

Koch

Borisov

et al. 2018

Front. Behav. Neurosci.

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Chronic pain (CP) is linked to changes in cognitive function. However, little is known about its influence on number sense, despite the fact that intact numerical-spatial processing is a prerequisite for valid scale-based pain assessments. This study aimed to elucidate whether number sense is changed in CP, to determine if changes have an impact on pain assessments using pain rating scales and what patient factors might contribute. N = 42 CP patients and n = 42 matched controls were analyzed (age range: 33–68 years). Numerical-spatial abilities were investigated by using number line tasks, where participants either estimated the position of a given number (position marking) or the value of a predefined mark (number naming). Pain intensity was assessed using numerical rating (NRS), verbal rating (VRS), and visual analog (VAS) scales. Additional measures included attention and working memory, verbal intelligence, medication and depression. Results revealed that in number naming, patients deviated more from expected (correct) responses than controls, and that VAS scores were significantly higher than both NRS and VRS and correlated with deviations in position making. Changes in number naming were predicted by pain intensity, sex and IQ but not by attention, memory or opioid medication. This article presents new insight on which cognitive mechanisms are influenced by CP with the focus on numerical spatial abilities. It could therefore provide useful knowledge in developing new pain assessment tools specifically for patients suffering from CP.

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Section: Discussionmentioning

confidence: 81%

The Influence of Chronic Pain and Cognitive Function on Spatial-Numerical Processing

Spindler

Koch

Borisov

et al. 2018

Front. Behav. Neurosci.

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“…Four diabetes-related complications were assessed–i.e. cardiovascular disease, neuropathic pain, retinopathy and chronic kidney disease–as described elsewhere [ 28 , 29 ]. Based on the Patient Health Questionnaire (PHQ) instrument for screening, diagnosing and measuring severity of depression, we categorised depression as: (1) no or minimal depressive symptoms (score 0–9); (2) minor depression (score 10–14); or (3) major depression (≥15) [ 30 , 31 ].…”

Section: Methodsmentioning

confidence: 99%

Differences in biopsychosocial profiles of diabetes patients by level of glycaemic control and health-related quality of life: The Maastricht Study

et al. 2017

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AimsTailored, patient-centred innovations are needed in the care for persons with type 2 diabetes mellitus (T2DM), in particular those with insufficient glycaemic control. Therefore, this study sought to assess their biopsychosocial characteristics and explore whether distinct biopsychosocial profiles exist within this subpopulation, which differ in health-related quality of life (HRQoL).MethodsCross-sectional study based on data from The Maastricht Study, a population-based cohort study focused on the aetiology, pathophysiology, complications, and comorbidities of T2DM. We analysed associations and clustering of glycaemic control and HRQoL with 38 independent variables (i.e. biopsychosocial characteristics) in different subgroups and using descriptive analyses, latent class analysis (LCA), and logistic regressions.ResultsIncluded were 840 persons with T2DM, mostly men (68.6%) and with a mean age of 62.6 (±7.7) years. Mean HbA1c was 7.1% (±3.2%); 308 patients (36.7%) had insufficient glycaemic control (HbA1c>7.0% [53 mmol/mol]). Compared to those with sufficient control, these patients had a significantly worse-off status on multiple biopsychosocial factors, including self-efficacy, income, education and several health-related characteristics. Two ‘latent classes’ were identified in the insufficient glycaemic control subgroup: with low respectively high HRQoL. Of the two, the low HRQoL class comprised about one-fourth of patients and had a significantly worse biopsychosocial profile.ConclusionsInsufficient glycaemic control, particularly in combination with low HRQoL, is associated with a generally worse biopsychosocial profile. Further research is needed into the complex and multidimensional causal pathways explored in this study, so as to increase our understanding of the heterogeneous care needs and preferences of persons with T2DM, and translate this knowledge into tailored care and support arrangements.

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“…Subgroup analyses were conducted for costs and quality of life based on age categories (40-65 and 65-75 years), gender (men/women), socio-economic status measured in terms of educational level [low (no education to lower vocational education), medium (intermediate vocational education or higher secondary education) and high (higher professional or academic education)], and number of diabetes complications for people with type 2 diabetes (0, 1 and ≥2). Diabetes complications included history of cardiovascular disease (yes/ no), retinopathy (yes/no based on fundus photographs), neuropathic pain (DN4 scale outcome score of ≥3) [15], and nephropathy (chronic kidney disease, defined as an estimated GFR <60 ml/min per 1.73m 2 and/or a urinary albumin excretion rate ≥30 mg/24 h) [16][17][18].…”

Section: Independent Variablesmentioning

confidence: 99%

Burden of disease of type 2 diabetes mellitus: cost of illness and quality of life estimated using the Maastricht Study

et al. 2020

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Aims To estimate the societal costs and quality of life of people with type 2 diabetes and to compare these results with those of people with normal glucose tolerance or prediabetes. Methods Data from 2915 individuals from the population‐based Maastricht Study were included. Costs were assessed through a resource‐use questionnaire completed by the participants; cost prices were based on Dutch costing guidelines. Quality of life was expressed in utilities using the Dutch EuroQol 5D‐3L questionnaire and the SF‐36 health survey. Based on normal fasting glucose and 2‐h plasma glucose values, participants were classified into three groups: normal glucose tolerance (n = 1701); prediabetes (n = 446); or type 2 diabetes (n = 768). Results Participants with type 2 diabetes had on average 2.2 times higher societal costs than those with normal glucose tolerance (€3,006 and €1,377 per 6 months, respectively) and had lower utilities (0.77 and 0.81, respectively). No significant differences were found between participants with normal glucose tolerance and those with prediabetes. Subgroup analyses showed that higher age, being female and having two or more diabetes‐related complications resulted in higher costs (P < 0.05) and lower utilities. Conclusions This study showed that people with type 2 diabetes have substantially higher societal costs and lower quality of life than people with normal glucose tolerance. The results provide important input for future model‐based economic evaluations and for policy decision‐making.

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Lower verbal intelligence is associated with diabetic complications and slower walking speed in people with Type 2 diabetes: the Maastricht Study

Cited by 9 publications

References 28 publications

The Influence of Chronic Pain and Cognitive Function on Spatial-Numerical Processing

The Influence of Chronic Pain and Cognitive Function on Spatial-Numerical Processing

Differences in biopsychosocial profiles of diabetes patients by level of glycaemic control and health-related quality of life: The Maastricht Study

Burden of disease of type 2 diabetes mellitus: cost of illness and quality of life estimated using the Maastricht Study

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