medwireNews: Researchers find psychologic resilience to be predictive of glycated hemoglobin (HbA1c) levels in the 3 years after type 1 diabetes diagnosis.
Moreover, low resilience was associated with poorer mental health status (measured on the SF-12 quality of life questionnaire) at baseline and with its deterioration over the first 2 years after diabetes diagnosis in people with type 1 or type 2 diabetes.
Simon Brackley (National Institute for Health Research, Exeter, UK) presented the findings at the 58th EASD Annual Meeting in Stockholm, Sweden.
“The implications of this is that we could target these individuals with low resilience and either give them targeted diabetes team support, consider trying to improve their resilience, or give more targeted mental health support, which might improve both their mental health and their glycemic outcomes,” he said.
The 1267 study participants came from the StartRight cohort, a multicenter prospective cohort study of adults with a recent diabetes diagnosis, which included the Connor-Davidson Resilience Scale (CD-RISC) as a secondary outcome measure.
Among the 462 people diagnosed with type 1 diabetes, each 10-point increase in baseline resilience was significantly associated with an average 4.1 mmol/mol lower HbA1c during the 3 years of follow-up, after adjusting for age, sex, BMI and baseline HbA1c.
This relationship appeared strongest in those with severe insulin deficiency (urinary C-peptide: creatinine ratio <0.2 nmol/mmol), with each 10-point increase in resilience associated with HbA1c being 6.6 mmol/mol lower during follow-up, compared with 3.7 mmol/mol lower for those who were not severely insulin deficient.
“I’m not suggesting we use this as a prediction model, but if we were to consider the population averages, we see a difference of approximately 10 mmol/mol, which is definitely a clinically significant effect size,” said Brackley.
By contrast, there was no association between resilience and glycemic outcomes in the 573 people diagnosed with type 2 diabetes. Each 10-point increase in resilience was associated with 1.1 mmol/mol lower HbA1c during follow-up, which was not statistically significant (p=0.06).
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