The Association of Burnout and Vital Exhaustion With Type 2 Diabetes: A Systematic Review and Meta-Analysis. Issue 9 (2nd November 2021)

• Record Type: Journal Article
• Authors: Strikwerda, Marije; Beulens, Joline W.; Remmelzwaal, Sharon; Schoonmade, Linda J.; van Straten, Annemieke; Schram, Miranda T.; Elders, Petra J.; Rutters, Femke
• Is Part Of: Psychosomatic medicine. Volume 83:Issue 9(2021)
• Page Start: 1013
• Page End: 1030
• Publication Date: 2021-11-02
• Subjects: burnout -- vital exhaustion -- glycemic control -- type 2 diabetes -- systematic review -- meta-analysis -- glycated hemoglobin A1c -- glucose -- CI = confidence interval -- GRADE = Grading of Recommendations, Assessment, Development and Evaluation -- HbA1c = glycated hemoglobin A1c -- HOMA-IR = homeostatic model assessment insulin resistance -- OR = odds ratio -- T2D = type 2 diabetes; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000995
• Languages: English
• ISSNs: 0033-3174

Abstract

Abstract : Supplemental digital content is available in the text. ABSTRACT: Objective: This study aimed to investigate the association of burnout and vital exhaustion with measures of glycemic control and type 2 diabetes (T2D) in a systematic review and meta-analysis. Methods: PubMed, Embase, and PsycINFO were searched from inception to April 2, 2020. Data extraction and quality assessment were performed using the Effective Public Health Practice Project tool. When possible, results were meta-analyzed using random-effects models and rated using the Grading of Recommendations, Assessment, Development and Evaluation. Results: A total of 5317 titles/abstracts were screened, 140 articles were read full text, of which 29 studies were included. Eighteen studies were cross-sectional, three prospective and eight were case-control studies. Burnout and vital exhaustion were significantly associated with T2D, with a pooled odds ratio of 1.8 (95% confidence interval [CI] = 1.4 to 2.4, I 2 = 79%; 9 studies). Glycated hemoglobin A1c levels were not significantly higher in people with burnout and vital exhaustion, compared to those without, with a pooled standardized mean difference of 0.35 (95% CI = −0.62 to 1.33, I 2 = 98%; 7 studies). In addition, no differences in glucose levels were observed (standardized mean difference = 0.02, 95% CI = −0.26 to 0.30, I 2 = 90%; 9 studies). Sensitivity analyses showed no decrease in heterogeneity when excluding studies with low quality ( I 2 glucose = 89%) or studies with a study n < 40 population ( I 2 T2D = 77%). The level of Grading of Recommendations, Assessment, Development and Evaluation evidence was moderate to low quality because of 18 studies having a cross-sectional design. Conclusions: Burnout and vital exhaustion might be associated with a higher risk of T2D, but not with glycemic control. Methodological shortcomings and high heterogeneity of the studies included complicate the interpretation of our results.