Determinants of Stress and Obstacles to Diabetes-Related Quality of Life in Adults With Type 2 Diabetes: A Cross-Sectional Interaction-Mediation Analysis.
Siti Fadlilah, Santi Damayanti, Maria Dyah Kurniasari and 5 others
PMID 42503708WHAT IT FOUND
In 1815 adults with type 2 diabetes, abnormal fasting glucose and diabetes-related stress were most strongly associated with obstacles to diabetes-related quality of life.
Multiple cardiometabolic abnormalities together were linked to higher risk.
Key findings
01579 of 1815 participants had high stress, and 1171 reported obstacles to diabetes-related quality of life.
02Abnormal fasting glucose and diabetes-related stress were the strongest predictors of obstacles to diabetes-related quality of life.
03Risk increased cumulatively with the number of abnormal cardiometabolic factors; when all factors were abnormal, the adjusted odds ratio for obstacles was 52.097.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot establish cause and effect, including whether high fasting glucose or stress caused quality-of-life obstacles. Stress and obstacles were self-reported, so recall or social desirability bias may affect the answers. Fasting glucose was measured at one time point and may not reflect long-term glycemic control. The sample was from Indonesian public health centers and excluded hospitalized people, cognitive impairment, acute psychiatric symptoms, chronic kidney disease, heart failure, or stroke, so it may not apply to other settings or more complex patients. The insulin-use domain of the obstacle questionnaire was omitted because most participants were not insulin users, so insulin-related obstacles are not fully captured. The model explained 30% of variance in quality-of-life obstacles, so many factors were not accounted for.
Declared interests
The study was funded by The National Science and Technology Council (NSTC), Taiwan. The supplied text does not report a competing-interests declaration.
The easy way to misread this
Do not read the strong associations or mediation paths as proof that lowering fasting glucose or stress will improve quality of life. This was a cross-sectional study, so it cannot show that treatment caused change.