Diabetes-related distress and daily cortisol output in people with Type 2 diabetes. (November 2020)

• Record Type: Journal Article
• Authors: Bawa, Hetashi; Poole, Lydia; Cooke, Debbie; Panagi, Laura; Steptoe, Andrew; Hackett, Ruth A.
• Is Part Of: Diabetes research and clinical practice. Volume 169(2020)
• Publication Date: 2020-11
• Subjects: Type 2 Diabetes -- Diabetes-related distress -- Cortisol; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108472
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: Diabetes-related distress is common in Type 2 Diabetes and is linked with poor diabetes control. However, mechanisms underlying this association are unclear. One pathway that could be involved is neuroendocrine dysfunction, as Type 2 Diabetes is associated with altered diurnal cortisol output. This study investigated the link between diabetes-related distress and diurnal cortisol output. Methods: 134 people with Type 2 Diabetes provided 5 cortisol samples over the course of a day. Multivariate linear regression models were used to assess whether overall and sub-domains of diabetes-related distress measured by the Diabetes Distress Scale, predicted cortisol parameters (waking cortisol, cortisol awakening response, cortisol slope and evening cortisol). Results: Physician-related distress was associated with greater waking ( B = 2.747, p = .015) and evening cortisol ( B = 1.375, p = .014), and a blunted cortisol awakening response ( B = −3.472, p = .038) adjusting for age, sex, income, body mass index, smoking and time of awakening. No associations were detected for overall distress, emotional, interpersonal or regimen distress. Conclusion: Physician-related distress was associated with alterations in daily cortisol output. Longitudinal research is required to understand how physician-related distress is associated with diurnal cortisol patterning over time.