Emotional Distress and Cardiovascular Disease Risk among Participants enrolled in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study

Authors

• Gladys Crespo-Ramos, Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA.
• Ionut Bebu, The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD.
• Heidi Krause-Steinrauf, The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD.
• Claire J. Hoogendoorn, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
• Ran Fang, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
• Dominic Ehrmann, Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany; Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany.
• Caroline Presley, Department of Medicine (General Internal and Preventive Medicine) University of Alabama, Birmingham, Birmingham, AL.
• Aanand D. Naik, School of Public Health, University of Texas Health Science Center, Houston, Texas, USA.
• Aimee Katona, University of Michigan, Ann Arbor, MI, United States.
• Elizabeth A. Walker, Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA.
• Andrea Cherrington, Department of Medicine (General Internal and Preventive Medicine) University of Alabama, Birmingham, Birmingham, AL.
• Jeffrey S. Gonzalez, Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, New York, USA. Electronic address: grademail@bsc.gwu.edu.

Document Type

Journal Article

Publication Date

6-30-2023

Journal

Diabetes research and clinical practice

DOI

10.1016/j.diabres.2023.110808

Keywords

cardiovascular complications; depression; diabetes-related distress; type 2 diabetes

Abstract

AIMS: People with type 2 diabetes (T2DM) have an increased risk of cardiovascular disease (CVD). We examined depressive symptoms (DS) and diabetes distress (DD) in relation to the estimated 10-year risk of CVD in adults with T2DM enrolled in the GRADE Emotional Distress Substudy. METHODS: Linear regression models examined the associations of baseline DS and DD with estimated 10-year risk of CVD using the Atherosclerotic Cardiovascular Disease (ASCVD) risk score, adjusting for age, sex, race/ethnicity, education, income, diabetes duration, diabetes-related complications, and HbA1c. RESULTS: A total of 1,605 GRADE participants were included: 54% Non-Latino (NL) White, 19% Latino, 18% NL-Black, 66% male, mean age 57.5 (SD=10.25) years, diabetes duration 4.2 (SD=2.8) years, and HbA1c 7.5% (SD=0.5%). After incorporating covariates, only DS, especially cognitive-affective symptoms, were associated with ASCVD risk (estimate=0.15 [95% CI: 0.04, 0.26], p=0.006). Higher DS remained significantly associated with higher ASCVD risk when adding DD to covariates (estimate=0.19 [95% CI: 0.07, 0.30], p=0.002). DD was not associated with ASCVD risk when accounting for covariates. CONCLUSIONS: Depressive symptoms, particularly cognitive-affective symptoms, are associated with increased 10-year predicted ASCVD risk among adults with early T2DM. Diabetes distress is not significantly associated with the predicted ASCVD risk when accounting for covariates.

APA Citation

Crespo-Ramos, Gladys; Bebu, Ionut; Krause-Steinrauf, Heidi; Hoogendoorn, Claire J.; Fang, Ran; Ehrmann, Dominic; Presley, Caroline; Naik, Aanand D.; Katona, Aimee; Walker, Elizabeth A.; Cherrington, Andrea; and Gonzalez, Jeffrey S., "Emotional Distress and Cardiovascular Disease Risk among Participants enrolled in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study" (2023). GW Authored Works. Paper 2673.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2673

Department

Biostatistics and Bioinformatics