High diabetes fatalism scores (DFS) strongly correlate with poor glycemic control in individuals with type 2 diabetes (T2D). Although relationships between diabetes fatalism (DF) and outcomes have been established in cross-sectional data, gaps remain regarding its longitudinal effect on clinical outcomes and quality of life (QOL). This study used results from an RCT to examine the longitudinal impact of DF on clinical outcomes and QOL in African Americans (AA) with T2D. Data were collected from AA adults (n=200) with poorly controlled T2D (HbA1c ≥8%) randomly assigned to one of two groups and received 12 sessions of telephone-delivered diabetes knowledge/skills training or usual care. HbA1c, systolic blood pressure, diastolic blood pressure, physical health-related (PCS), and mental health-related (MCS) QOL were measured at baseline, 3-, 6-, 9-, and 12 months. DF was also measured at all time points with a validated 12-item DFS. DF was investigated using validated scoring of the entire scale and the emotional distress subscale. Longitudinal mixed models with random effects were run for each of the five outcomes, adjusting for treatment, time, treatment-by-time interaction, and baseline scores of the outcome of interest. Participants were primarily female and unemployed. A statistically significant negative relationship was found between the total DFS and MCS over time (β= -0.01, 95% CI -0.17, -0.03). There was also a significant longitudinal relationship between the emotional subscale of the DFS and HbA1c (β=0.02, 95% CI 0.004, 0.04); PCS (β= -0.16, 95% CI -0.27, -0,06), and MCS (β= -0.23, 95% CI -0.34, -0.11). Higher diabetes fatalism is associated with lower MCS over time. Higher scores on the emotional distress subscale of DFS are associated with higher HbA1c, lower PCS, and lower MCS over time. This study establishes that the effect of diabetes fatalism on diabetes outcomes is persistent over time, and the emotional distress component is particularly detrimental to diabetes outcomes over time.
S.C. Iregbu: None. R.J. Walker: None. L.E. Egede: None.
