Conquering diabetes by overcoming psychological barriers and embracing health

Abstract

Living with chronic conditions like diabetes mellitus (DM) or insulin resistance (IR) requires significant self-management, adding to daily life stressors. This stress, known as diabetes distress, along with health empowerment from proper diet and lifestyle, and motivation to eat healthily, greatly impacts quality of life and disease outcomes. Different patient subgroups (type 1 diabetic (T1DM), type 2 diabetic (T2DM), and insulin resistant (IR) individuals) face these challenges differently. This research aims to compare people with IR and DM to those without, and to compare IR, T1DM and T2DM subgroups on psychological factors. Data was collected via an online questionnaire from 746 participants (average age 37.5 years). Among them, 405 had IR (N = 177) or DM (Type 1: N = 116; Type 2: N = 112), and 341 were controls. Results showed that T2DM individuals scored lower than controls on Identified Regulation, Interoceptive Awareness, and Search for Meaning in Life, while the IR group had higher body-mind disconnection. T1DM individuals experienced the highest emotional distress due to the disease but the lowest distress from regular check-ups compared to T2DM and IR groups. The gradient boosting classification model indicated that IR and T1DM groups are homogeneous, whereas T2DM is heterogeneous, with significant within-group variation in disease experience and management. Despite similarities in daily life challenges, significant differences exist in disease experience among the groups. Individual characteristics of T2DM individuals further diversify their attitudes towards disease management.

Keywords: Body responsiveness; Diabetes distress; Diabetes mellitus; Health empowerment; Insulin resistance; Meaning in life; Motivation for healthy eating.

Fig. 1

Group scores visualized as boxplots presented on separate panels. The significant group differences can be seen on the BRQ I, BRQ PD, MHES Identified regulation and MLQ Search subscales. The groups: C Control; IR Insulin resistant; T1  Type 1 diabetes; T2  Type 2 diabetes. The variables: HES Health Empowerment Scale, MHES  Motivation for Healthy Eating Scale, BRQ_I  Body Responsiveness Scale Importance of Interoceptive Awareness factor, BRQ_PD  Body Responsiveness Scale Perceived Disconnection factor, MLQ   Meaning in Life Questionnaire.

Fig. 2

Patient group scores (IR  Insulin resistant; T1  Type 1 diabetes; T2   Type 2 diabetes) on the four subscales (EB   Emotional Burden, PD  Physician Distress, RB  Regimen Burden, ID  Interpersonal Distress) of the Diabetes Distress Scale (DDS) visualized as boxplots presented on separate panels. Significant group differences can be found on the Emotional Burden (EB) and Physician Distress (PD) subscales.

Fig. 3

ROC curves for the three patient groups based on the results of the boosting classification model.

Fig. 4

The relative influence values of independent variables in the boosting classification model.