Emotional well-being and social and economic disadvantage in severely obese people with type 2 diabetes: Results from Diabetes MILES – Australia — ASN Events
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Emotional well-being and social and economic disadvantage in severely obese people with type 2 diabetes: Results from Diabetes MILES – Australia (#257)

Jessica L Browne 1 2 , John B Dixon 3 4 , Prasuna Reddy 5 , Frans Pouwer 6 , Jane Speight 1 2 7
  1. The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia - Vic, Melbourne, VIC, Australia
  2. Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, Burwood, VIC, Australia
  3. Vascular and Hypertension Division, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
  4. Primary Health Research Unit, Monash University, Clayton, VIC, Australia
  5. School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
  6. Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
  7. AHP Research, Hornchurch, Essex, UK

AIMS: People with type 2 diabetes (T2DM) typically have poor emotional well-being compared with the general population. However, we know little about the well-being of people with T2DM and co-morbid severe obesity. Our aims were to examine the emotional well-being of severely obese people and examine markers of social and economic disadvantage in this group using the Diabetes MILES – Australia dataset.

METHOD: Diabetes MILES – Australia was a national survey (postal and online) of 3,338 adults with diabetes focused on psychosocial issues; 59% (N=1,962) of whom had T2DM (59% of these BMI≥30). The survey included validated scales (e.g. depression (PHQ-9), anxiety (GAD-7)) and study-specific items (e.g. self-reported height, weight). A total of 530 (30%) respondents with T2DM were severely obese (BMI≥35; median BMI=41.6). In a case-controlled analysis, these cases were matched on gender, age, diabetes duration and insulin use with 530 controls (BMI<35; median BMI=28.2).

RESULTS: The severely obese group had higher depression scores (median (interquartile range)=6.0 (3-12)) than the control group (5.0 (2-10); p<0.001), and were more likely to experience moderate-severe symptoms of depression (37% versus 27%; p<0.001). The two groups did not differ on anxiety. The severely obese group, compared with the control group, were more likely to live alone (21% versus 17%), receive a disability pension (21% versus 15%), and earn ≤$40,000/year (51% versus 41%; all p<0.05), and less likely to be in paid employment (46% versus 53%), be tertiary educated (17% versus 26%), and to have health insurance (50% versus 60%; all p≤0.01).

CONCLUSIONS: People with T2DM and co-morbid severe obesity are more likely to report clinically relevant depressive symptoms and markers of social and economic disadvantage than people with T2DM who are not severely obese. Increased awareness of these issues may result in more person-centred clinical care, and realistic and appropriate healthcare goals.