Explaining psychological insulin resistance in adults with non-insulin-treated type 2 diabetes

The roles of diabetes distress and current medication concerns. Results from Diabetes MILES-Australia

E Holmes-Truscott, Timothy Skinner, Frans Pouwer, J Speight

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Aims: To investigate the contribution of general and diabetes-specific emotional wellbeing and beliefs about medicines in the prediction of insulin therapy appraisals in adults with non-insulin-treated type 2 diabetes.

    Methods: The sample included Diabetes MILES–Australia cross-sectional survey participants whose primary diabetes treatment was oral hypoglycaemic agents (N = 313; 49% women; mean ± SD age: 57 ± 9 years; diabetes duration: 7 ± 6 years). They completed validated measures of beliefs about the ‘harm’ and ‘overuse’ of medications in general (BMQ General); ‘concerns’ about and ‘necessity’ of current diabetes medications (BMQ Specific); negative insulin therapy appraisals (ITAS); depression (PHQ-9); anxiety (GAD-7), and diabetes distress (DDS-17). Factors associated with ITAS Negative scores were examined using hierarchical multiple regressions.

    Results: Twenty-two percent of the variance in ITAS Negative scores (52 ± 10), was explained by: number of complications (β = −.15, p = .005), DDS-17 subscale ‘emotional burden’ (β = .23, p < .001), and ‘concerns’ about current diabetes treatment (β = .29, p < .001). General beliefs about medications and general emotional wellbeing did not contribute significantly to the model.

    Conclusions: Psychological insulin resistance may reflect broader distress about diabetes and concerns about its treatment but not general beliefs about medicines, depression or anxiety. Reducing diabetes distress and current treatment concerns may improve attitudes towards insulin as a potential therapeutic option.

    Original languageEnglish
    Pages (from-to)75-82
    Number of pages8
    JournalPrimary Care Diabetes
    Volume10
    Issue number1
    DOIs
    Publication statusPublished - Feb 2016

    Fingerprint

    Type 2 Diabetes Mellitus
    Insulin Resistance
    Psychology
    Therapeutics
    Anxiety
    Depression
    Insulin

    Cite this

    @article{205aab30d6104843b3914366ddd2927e,
    title = "Explaining psychological insulin resistance in adults with non-insulin-treated type 2 diabetes: The roles of diabetes distress and current medication concerns. Results from Diabetes MILES-Australia",
    abstract = "Aims: To investigate the contribution of general and diabetes-specific emotional wellbeing and beliefs about medicines in the prediction of insulin therapy appraisals in adults with non-insulin-treated type 2 diabetes. Methods: The sample included Diabetes MILES–Australia cross-sectional survey participants whose primary diabetes treatment was oral hypoglycaemic agents (N = 313; 49{\%} women; mean ± SD age: 57 ± 9 years; diabetes duration: 7 ± 6 years). They completed validated measures of beliefs about the ‘harm’ and ‘overuse’ of medications in general (BMQ General); ‘concerns’ about and ‘necessity’ of current diabetes medications (BMQ Specific); negative insulin therapy appraisals (ITAS); depression (PHQ-9); anxiety (GAD-7), and diabetes distress (DDS-17). Factors associated with ITAS Negative scores were examined using hierarchical multiple regressions. Results: Twenty-two percent of the variance in ITAS Negative scores (52 ± 10), was explained by: number of complications (β = −.15, p = .005), DDS-17 subscale ‘emotional burden’ (β = .23, p < .001), and ‘concerns’ about current diabetes treatment (β = .29, p < .001). General beliefs about medications and general emotional wellbeing did not contribute significantly to the model. Conclusions: Psychological insulin resistance may reflect broader distress about diabetes and concerns about its treatment but not general beliefs about medicines, depression or anxiety. Reducing diabetes distress and current treatment concerns may improve attitudes towards insulin as a potential therapeutic option.",
    keywords = "insulin, oral antidiabetic agent, adult, anxiety, Article, Australia, depression, diabetes mellitus, disease duration, distress syndrome, emotion, female, health belief, human, insulin resistance, insulin treatment, major clinical study, male, mental stress, multiple regression, non insulin dependent diabetes mellitus, predictive value, priority journal, psychological well being, scoring system, treatment planning",
    author = "E Holmes-Truscott and Timothy Skinner and Frans Pouwer and J Speight",
    year = "2016",
    month = "2",
    doi = "10.1016/j.pcd.2015.06.006",
    language = "English",
    volume = "10",
    pages = "75--82",
    journal = "Primary Care Diabetes",
    issn = "1751-9918",
    publisher = "Elsevier",
    number = "1",

    }

    Explaining psychological insulin resistance in adults with non-insulin-treated type 2 diabetes : The roles of diabetes distress and current medication concerns. Results from Diabetes MILES-Australia. / Holmes-Truscott, E; Skinner, Timothy; Pouwer, Frans; Speight, J.

    In: Primary Care Diabetes, Vol. 10, No. 1, 02.2016, p. 75-82.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Explaining psychological insulin resistance in adults with non-insulin-treated type 2 diabetes

    T2 - The roles of diabetes distress and current medication concerns. Results from Diabetes MILES-Australia

    AU - Holmes-Truscott, E

    AU - Skinner, Timothy

    AU - Pouwer, Frans

    AU - Speight, J

    PY - 2016/2

    Y1 - 2016/2

    N2 - Aims: To investigate the contribution of general and diabetes-specific emotional wellbeing and beliefs about medicines in the prediction of insulin therapy appraisals in adults with non-insulin-treated type 2 diabetes. Methods: The sample included Diabetes MILES–Australia cross-sectional survey participants whose primary diabetes treatment was oral hypoglycaemic agents (N = 313; 49% women; mean ± SD age: 57 ± 9 years; diabetes duration: 7 ± 6 years). They completed validated measures of beliefs about the ‘harm’ and ‘overuse’ of medications in general (BMQ General); ‘concerns’ about and ‘necessity’ of current diabetes medications (BMQ Specific); negative insulin therapy appraisals (ITAS); depression (PHQ-9); anxiety (GAD-7), and diabetes distress (DDS-17). Factors associated with ITAS Negative scores were examined using hierarchical multiple regressions. Results: Twenty-two percent of the variance in ITAS Negative scores (52 ± 10), was explained by: number of complications (β = −.15, p = .005), DDS-17 subscale ‘emotional burden’ (β = .23, p < .001), and ‘concerns’ about current diabetes treatment (β = .29, p < .001). General beliefs about medications and general emotional wellbeing did not contribute significantly to the model. Conclusions: Psychological insulin resistance may reflect broader distress about diabetes and concerns about its treatment but not general beliefs about medicines, depression or anxiety. Reducing diabetes distress and current treatment concerns may improve attitudes towards insulin as a potential therapeutic option.

    AB - Aims: To investigate the contribution of general and diabetes-specific emotional wellbeing and beliefs about medicines in the prediction of insulin therapy appraisals in adults with non-insulin-treated type 2 diabetes. Methods: The sample included Diabetes MILES–Australia cross-sectional survey participants whose primary diabetes treatment was oral hypoglycaemic agents (N = 313; 49% women; mean ± SD age: 57 ± 9 years; diabetes duration: 7 ± 6 years). They completed validated measures of beliefs about the ‘harm’ and ‘overuse’ of medications in general (BMQ General); ‘concerns’ about and ‘necessity’ of current diabetes medications (BMQ Specific); negative insulin therapy appraisals (ITAS); depression (PHQ-9); anxiety (GAD-7), and diabetes distress (DDS-17). Factors associated with ITAS Negative scores were examined using hierarchical multiple regressions. Results: Twenty-two percent of the variance in ITAS Negative scores (52 ± 10), was explained by: number of complications (β = −.15, p = .005), DDS-17 subscale ‘emotional burden’ (β = .23, p < .001), and ‘concerns’ about current diabetes treatment (β = .29, p < .001). General beliefs about medications and general emotional wellbeing did not contribute significantly to the model. Conclusions: Psychological insulin resistance may reflect broader distress about diabetes and concerns about its treatment but not general beliefs about medicines, depression or anxiety. Reducing diabetes distress and current treatment concerns may improve attitudes towards insulin as a potential therapeutic option.

    KW - insulin

    KW - oral antidiabetic agent

    KW - adult

    KW - anxiety

    KW - Article

    KW - Australia

    KW - depression

    KW - diabetes mellitus

    KW - disease duration

    KW - distress syndrome

    KW - emotion

    KW - female

    KW - health belief

    KW - human

    KW - insulin resistance

    KW - insulin treatment

    KW - major clinical study

    KW - male

    KW - mental stress

    KW - multiple regression

    KW - non insulin dependent diabetes mellitus

    KW - predictive value

    KW - priority journal

    KW - psychological well being

    KW - scoring system

    KW - treatment planning

    UR - http://www.scopus.com/inward/record.url?scp=84954381804&partnerID=8YFLogxK

    U2 - 10.1016/j.pcd.2015.06.006

    DO - 10.1016/j.pcd.2015.06.006

    M3 - Article

    VL - 10

    SP - 75

    EP - 82

    JO - Primary Care Diabetes

    JF - Primary Care Diabetes

    SN - 1751-9918

    IS - 1

    ER -