Gender, age, and socioeconomic position-specific associations between illness perception and diabetes-related distress: Cross-sectional analysis among people with type 2 diabetes

Aim: Around one-third of people with type 2 diabetes (T2DM) suffer from diabetes-related distress (DRD). Understanding risk factors could aid in targeted interventions to lower distress and improve quality of life. Although the way people perceive their illness – illness perceptions – have been related to DRD, studies so far have been small and it is unclear whether gender, age and socioeconomic position (SEP) affect the association. Therefore, this study aims to investigate the age-, gender-, and SEP-specific relationship between illness perceptions and DRD.

Methods: Analyses were based on cross-sectional data from people with T2DM (n= 1,215, 53.8% men, mean age 63.4). Illness perceptions were measured using the brief Illness Perception Questionnaire (B-IPQ) and DRD with the Problem Areas In Diabetes (PAID-5). We related illness perception scores and perceived causes of T2DM to DRD using linear regression models, adjusting for gender, age, SEP, and diabetes duration. Interactions with age, gender, and SEP were tested, and stratified analyses were run if significant.

Results: One SD increase in the illness perception score related to a 2.89 (95% confidence interval (CI): 2.72; 3.06) increase in DRD. Women and people below 60 years had a stronger relation between negative illness perceptions and DRD compared to men and older people. People attributing T2DM to psychological causes compared to non-modifiable ones had more DRD.

Conclusions: Overall, a more threatening illness perception was more strongly related to DRD in women and younger individuals with T2DM in this cross-sectional study. Though requiring validation, our findings therefore highlight possible targets for risk stratification.