Associations between diabetes-related symptoms, glycemic control, and health-related quality of life in adult Samoans Diabetes-related symptoms in adult Samoans
Main Article Content
Keywords
Type 2 Diabetes, Samoa, DSC-R, Health-related quality of life
Abstract
Aim
The prevalence of Type 2 diabetes in Samoa has increased substantially over the last 30 years. Identifying common symptoms in those living with diabetes may be instrumental in directing those at risk to seek early evaluation, diagnosis, and treatment. Additionally, identifying associations between diabetes experiences and health-related quality of life is useful for understanding the lived experience of having diabetes in this setting. Here we present the first description of diabetes-related symptoms in an adult cohort of Samoans with diabetes and prediabetes and describe associations between symptom presence and sex, glycemic control (HbA1c ≥ 8.0%), and health-related quality of life (HRQL). We also assessed whether reported symptoms were independently associated, when adjusting for other factors, with increased odds of having diabetes.
METHODS
Analyses were conducted on n = 123 adult Samoan participants selectively sampled from the observational cohort Soifua Manuia study, and who were living with either prediabetes or diabetes. Participants completed a series of anthropometric, biochemical, and questionnaire measures including the Revised Diabetes Symptoms Checklist (DSC-R) questionnaire between 2017-2019. Differences in symptom presence by sex, diabetes status (prediabetes vs. diabetes), glycemic control (HbA1c < or ≥ 8.0%), and HRQL were assessed using Independent Sample T-tests, Mann Whitney U tests and Chi-square tests of association. Multivariate logistic regression was used to assess which symptoms, when controlling for other factors, were associated with increased odds of having diabetes.
RESULTS
In a small sample of adult Samoans, we observed high symptom burdens among those with prediabetes and diabetes, and sex differences in the reported impact of diabetes symptoms on health-related quality of life. We identified three specific symptoms – frequent urination, difficulty thinking clearly, and chest/heart pains – that may be useful indicators of diabetes in this setting.
DISCUSSION
A high prevalence of symptoms was observed among those with prediabetes and among those with diabetes. It is recommended that individuals experiencing any of the measured symptoms seek early evaluation and engage in diabetes self-care behaviors to prevent diabetes-related complications and/or progression to diabetes among those in the early stages of the disease.
References
References
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2. Hawley, N.L. and S.T. McGarvey, Obesity and Diabetes in Pacific Islanders: the Current Burden and the Need for Urgent Action. Current Diabetes Reports, 2015. 15(5): p. 29.
3. Lin, S., et al., Trends in diabetes and obesity in Samoa over 35 years, 1978-2013. Diabetic medicine : a journal of the British Diabetic Association, 2017. 34(5): p. 654-661.
4. Rivara., et al., Care cascade engagement and characteristics of diabetes awareness in adult Samoans in 2010 and 2018, in American Diabetes Association. 2021: Washington DC (Virtual).
5. Clark, N.G., K.M. Fox, and S. Grandy, Symptoms of Diabetes and Their Association With the Risk and Presence of Diabetes. Diabetes Care, 2007. 30(11): p. 2868.
6. Ramachandran, A., Know the signs and symptoms of diabetes. The Indian journal of medical research, 2014. 140(5): p. 579-581.
7. Al-Shehri, A.H., et al., Health-related quality of life in type 2 diabetic patients. Annals of Saudi medicine, 2008. 28(5): p. 352-360.
8. Barsky, A.J., H.M. Peekna, and J.F. Borus, Somatic Symptom Reporting in Women and Men. Journal of General Internal Medicine, 2001. 16(4): p. 266-275.
9. Müller, N., et al., Is there an HbA1c Threshold for Symptoms of Chronic Hyperglycemia? Exp Clin Endocrinol Diabetes, (EFirst).
10. Pfalzgraf, A. and D. Nau, THE RELATIONSHIP OF DIABETES SYMPTOMS AND HEALTH-RELATED QUALITY OF LIFE. Value in Health, 2001. 4(2): p. 58-58.
11. CIA. The World Factbook [Samoa]. 2019 [cited 2019 2/20/2020]; Available from: https://www.cia.gov/library/publications/the-world-factbook/geos/ws.html.
12. Hawley, N.L., et al., Exploring the Paradoxical Relationship of a Creb 3 Regulatory Factor Missense Variant With Body Mass Index and Diabetes Among Samoans: Protocol for the Soifua Manuia (Good Health) Observational Cohort Study. JMIR Res Protoc, 2020. 9(7): p. e17329.
13. Arbuckle, R.A., et al., Psychometric evaluation of the Diabetes Symptom Checklist-Revised (DSC-R)--a measure of symptom distress. Value Health, 2009. 12(8): p. 1168-75.
14. Grootenhuis, P.A., et al., Development of a Type 2 Diabetes Symptom Checklist: a Measure of Symptom Severity. Diabetic Medicine, 1994. 11(3): p. 253-261.
15. Ware, J., et al., How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey, ed. QualityMetric. 2001, Boston: QualityMetric.
16. Ziaee, A., A. Afaghi, and M. Sarreshtehdari, Effect of low glycemic load diet on glycated hemoglobin (HbA1c) in poorly-controlled diabetes patients. Global journal of health science, 2011. 4(1): p. 211-216.
17. Crowley, M.J., et al., Factors associated with persistent poorly controlled diabetes mellitus: clues to improving management in patients with resistant poor control. Chronic Illn, 2014. 10(4): p. 291-302.
18. Oshitari, T., et al., Effect of Chronic Hyperglycemia on Intraocular Pressure in Patients With Diabetes. American Journal of Ophthalmology, 2007. 143(2): p. 363-365.
19. Sherwani, S.I., et al., Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker insights, 2016. 11: p. 95-104.
20. Gåfvels, C., F. Lithner, and B. Börjeson, Living with Diabetes: Relationship to Gender, Duration and Complications. A Survey in Northern Sweden. Diabetic Medicine, 1993. 10(8): p. 768-773.
21. Siddiqui, M.A., M.F. Khan, and T.E. Carline, Gender differences in living with diabetes mellitus. Materia socio-medica, 2013. 25(2): p. 140-142.
22. Svenningsson, I., et al., Type 2 diabetes: perceptions of quality of life and attitudes towards diabetes from a gender perspective. Scandinavian Journal of Caring Sciences, 2011. 25(4): p. 688-695.
23. Conway, B.N., et al., The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. PLOS ONE, 2018. 13(1): p. e0190993.
24. Narayan, K.M.V., et al., Effect of BMI on Lifetime Risk for Diabetes in the U.S. Diabetes Care, 2007. 30(6): p. 1562.
25. Cunningham-Myrie, C., et al., Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country. Tropical Medicine & International Health, 2013. 18(11): p. 1365-1378.
26. Weycker, D., et al., Excess risk of diabetes in persons with hypertension. Journal of Diabetes and its Complications, 2009. 23(5): p. 330-336.
27. Drivsholm, T., et al., Symptoms, signs and complications in newly diagnosed type 2 diabetic patients, and their relationship to glycaemia, blood pressure and weight. Diabetologia, 2005. 48(2): p. 210-214.
28. Nasri, H. and M. Rafieian-Kopaei, Metformin: Current knowledge. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2014. 19(7): p. 658-664.
29. Maric-Bilkan, C., Sex differences in micro- and macro-vascular complications of diabetes mellitus. Clinical Science, 2017. 131(9): p. 833-846.
30. Singh, S.S., et al., Sex difference in the incidence of microvascular complications in patients with type 2 diabetes mellitus: a prospective cohort study. Acta Diabetol, 2020. 57(6): p. 725-732.
31. Gedebjerg, A., et al., Prevalence of micro- and macrovascular diabetes complications at time of type 2 diabetes diagnosis and associated clinical characteristics: A cross-sectional baseline study of 6958 patients in the Danish DD2 cohort. J Diabetes Complications, 2018. 32(1): p. 34-40.
32. Aaberg, M.L., et al., Gender differences in the onset of diabetic neuropathy. Journal of Diabetes and its Complications, 2008. 22(2): p. 83-87.
33. Kamenov, Z.A., R.A. Parapunova, and R.T. Georgieva, Earlier development of diabetic neuropathy in men than in women with type 2 diabetes mellitus. Gender Medicine, 2010. 7(6): p. 600-615.
34. Booya, F., et al., Potential risk factors for diabetic neuropathy: a case control study. BMC Neurology, 2005. 5(1): p. 24.
35. Hicks, C.W. and E. Selvin, Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Current Diabetes Reports, 2019. 19(10): p. 86.
36. Collins, V.R., et al., High Prevalence of Diabetic Retinopathy and Nephropathy in Polynesians of Western Samoa. Diabetes Care, 1995. 18(8): p. 1140.
37. LaMonica, L.C., et al., The Soifua Manuia Telemedicine Eye Screening Program in a High-Risk Population of Samoans with Diabetes. Investigative Ophthalmology & Visual Science, 2019. 60(9): p. 1067-1067.
38. Grosso, A., et al., Hypertensive retinopathy revisited: some answers, more questions. British Journal of Ophthalmology, 2005. 89(12): p. 1646.
39. Singleton, J.R. and A.G. Smith, Neuropathy associated with prediabetes: what is new in 2007? Curr Diab Rep, 2007. 7(6): p. 420-4.
40. Stino, A.M. and A.G. Smith, Peripheral neuropathy in prediabetes and the metabolic syndrome. Journal of Diabetes Investigation, 2017. 8(5): p. 646-655.
41. Lamparter, J., et al., Prevalence and associations of diabetic retinopathy in a large cohort of prediabetic subjects: The Gutenberg Health Study. Journal of Diabetes and its Complications, 2014. 28(4): p. 482-487.
42. Diabetes Prevention Program Research, G., The prevalence of retinopathy in impaired glucose tolerance and recent-onset diabetes in the Diabetes Prevention Program. Diabetic Medicine, 2007. 24(2): p. 137-144.
43. Ballard, D.J., et al., Risk Factors for Diabetic Retinopathy: A Population-Based Study in Rochester, Minnesota. Diabetes Care, 1986. 9(4): p. 334.
44. Win Tin, S.T., et al., The prevalence of diabetes complications and associated risk factors in Pacific Islands countries. Diabetes Research and Clinical Practice, 2014. 103(1): p. 114-118.
45. Tuligenga, R.H., et al., Midlife type 2 diabetes and poor glycaemic control as risk factors for cognitive decline in early old age: a post-hoc analysis of the Whitehall II cohort study. The Lancet Diabetes & Endocrinology, 2014. 2(3): p. 228-235.
46. Kleefstra, N., et al., Cross-sectional relationship between glycaemic control, hyperglycaemic symptoms and quality of life in type 2 diabetes (ZODIAC-2). Neth J Med, 2005. 63(6): p. 215-21.
47. Schwartz, C.E. and M.A. Sprangers, Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Soc Sci Med, 1999. 48(11): p. 1531-48.
48. Sullivan, M.D., et al., Health-Related Quality of Life and Cost-Effectiveness Components of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial: Rationale and Design. The American Journal of Cardiology, 2007. 99(12, Supplement): p. S90-S102.
49. Wieringa, T.H., et al., Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics. BMJ open diabetes research & care, 2020. 8(1): p. e001146.
50. Hardin, J., “Healing is a Done Deal”: Temporality and Metabolic Healing Among Evangelical Christians in Samoa. Medical Anthropology, 2016. 35(2): p. 105-118.
51. Weaver, L.J. and E. Mendenhall, Applying Syndemics and Chronicity: Interpretations from Studies of Poverty, Depression, and Diabetes. Medical Anthropology, 2014. 33(2): p. 92-108.
52. Quillen, D.A., Common causes of vision loss in elderly patients. Am Fam Physician, 1999. 60(1): p. 99-108.
53. Schwarz, R., O. Krauss, and A. Hinz, Fatigue in the General Population. Oncology Research and Treatment, 2003. 26(2): p. 140-144.
54. Yu, T., et al., Retinopathy in Older Persons Without Diabetes and Its Relationship to Hypertension. Archives of Ophthalmology, 1998. 116(1): p. 83-89.
55. Vicario, A., et al., Hypertension and Cognitive Decline: Impact on Executive Function. The Journal of Clinical Hypertension, 2005. 7(10): p. 598-604.
56. Mier, N., et al., Health-related quality of life in a binational population with diabetes at the Texas-Mexico border. Rev Panam Salud Publica, 2008. 23(3): p. 154-63.
57. Adriaanse, M.C., et al., Diabetes-related symptoms and negative mood in participants of a targeted population-screening program for type 2 diabetes: The Hoorn Screening Study. Qual Life Res, 2005. 14(6): p. 1501-9.
58. Ciechanowski, P.S., et al., The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes. Gen Hosp Psychiatry, 2003. 25(4): p. 246-52.
59. Ludman, E.J., et al., Depression and diabetes symptom burden. Gen Hosp Psychiatry, 2004. 26(6): p. 430-6.
60. Wieringa, T.H., et al., Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics. BMJ Open Diabetes Res Care, 2020. 8(1).
61. Kalra, S., Y.P.S. Balhara, and A. Mithal, Cross-cultural variation in symptom perception of hypoglycemia. Journal of mid-life health, 2013. 4(3): p. 176-181.
62. Melby, M.K., M. Lock, and P. Kaufert, Culture and symptom reporting at menopause. Hum Reprod Update, 2005. 11(5): p. 495-512.
63. Park, J. and M.E. Johantgen, A Cross-Cultural Comparison of Symptom Reporting and Symptom Clusters in Heart Failure. Journal of Transcultural Nursing, 2016. 28(4): p. 372-380.
64. Kirk, J.K., et al., Diabetes symptoms and self-management behaviors in rural older adults. Diabetes Research and Clinical Practice, 2015. 107(1): p. 54-60.
65. Barko, R., et al., Perceptions of Diabetes Symptoms and Self-Management Strategies: A Cross-Cultural Comparison. Journal of Transcultural Nursing, 2011. 22(3): p. 274-281.
1. Hawley, N.L., et al., Prevalence of adiposity and associated cardiometabolic risk factors in the Samoan genome-wide association study. American journal of human biology: the official journal of the Human Biology Council, 2014. 26(4): p. 491-501.
2. Hawley, N.L. and S.T. McGarvey, Obesity and Diabetes in Pacific Islanders: the Current Burden and the Need for Urgent Action. Current Diabetes Reports, 2015. 15(5): p. 29.
3. Lin, S., et al., Trends in diabetes and obesity in Samoa over 35 years, 1978-2013. Diabetic medicine : a journal of the British Diabetic Association, 2017. 34(5): p. 654-661.
4. Rivara., et al., Care cascade engagement and characteristics of diabetes awareness in adult Samoans in 2010 and 2018, in American Diabetes Association. 2021: Washington DC (Virtual).
5. Clark, N.G., K.M. Fox, and S. Grandy, Symptoms of Diabetes and Their Association With the Risk and Presence of Diabetes. Diabetes Care, 2007. 30(11): p. 2868.
6. Ramachandran, A., Know the signs and symptoms of diabetes. The Indian journal of medical research, 2014. 140(5): p. 579-581.
7. Al-Shehri, A.H., et al., Health-related quality of life in type 2 diabetic patients. Annals of Saudi medicine, 2008. 28(5): p. 352-360.
8. Barsky, A.J., H.M. Peekna, and J.F. Borus, Somatic Symptom Reporting in Women and Men. Journal of General Internal Medicine, 2001. 16(4): p. 266-275.
9. Müller, N., et al., Is there an HbA1c Threshold for Symptoms of Chronic Hyperglycemia? Exp Clin Endocrinol Diabetes, (EFirst).
10. Pfalzgraf, A. and D. Nau, THE RELATIONSHIP OF DIABETES SYMPTOMS AND HEALTH-RELATED QUALITY OF LIFE. Value in Health, 2001. 4(2): p. 58-58.
11. CIA. The World Factbook [Samoa]. 2019 [cited 2019 2/20/2020]; Available from: https://www.cia.gov/library/publications/the-world-factbook/geos/ws.html.
12. Hawley, N.L., et al., Exploring the Paradoxical Relationship of a Creb 3 Regulatory Factor Missense Variant With Body Mass Index and Diabetes Among Samoans: Protocol for the Soifua Manuia (Good Health) Observational Cohort Study. JMIR Res Protoc, 2020. 9(7): p. e17329.
13. Arbuckle, R.A., et al., Psychometric evaluation of the Diabetes Symptom Checklist-Revised (DSC-R)--a measure of symptom distress. Value Health, 2009. 12(8): p. 1168-75.
14. Grootenhuis, P.A., et al., Development of a Type 2 Diabetes Symptom Checklist: a Measure of Symptom Severity. Diabetic Medicine, 1994. 11(3): p. 253-261.
15. Ware, J., et al., How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey, ed. QualityMetric. 2001, Boston: QualityMetric.
16. Ziaee, A., A. Afaghi, and M. Sarreshtehdari, Effect of low glycemic load diet on glycated hemoglobin (HbA1c) in poorly-controlled diabetes patients. Global journal of health science, 2011. 4(1): p. 211-216.
17. Crowley, M.J., et al., Factors associated with persistent poorly controlled diabetes mellitus: clues to improving management in patients with resistant poor control. Chronic Illn, 2014. 10(4): p. 291-302.
18. Oshitari, T., et al., Effect of Chronic Hyperglycemia on Intraocular Pressure in Patients With Diabetes. American Journal of Ophthalmology, 2007. 143(2): p. 363-365.
19. Sherwani, S.I., et al., Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomarker insights, 2016. 11: p. 95-104.
20. Gåfvels, C., F. Lithner, and B. Börjeson, Living with Diabetes: Relationship to Gender, Duration and Complications. A Survey in Northern Sweden. Diabetic Medicine, 1993. 10(8): p. 768-773.
21. Siddiqui, M.A., M.F. Khan, and T.E. Carline, Gender differences in living with diabetes mellitus. Materia socio-medica, 2013. 25(2): p. 140-142.
22. Svenningsson, I., et al., Type 2 diabetes: perceptions of quality of life and attitudes towards diabetes from a gender perspective. Scandinavian Journal of Caring Sciences, 2011. 25(4): p. 688-695.
23. Conway, B.N., et al., The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. PLOS ONE, 2018. 13(1): p. e0190993.
24. Narayan, K.M.V., et al., Effect of BMI on Lifetime Risk for Diabetes in the U.S. Diabetes Care, 2007. 30(6): p. 1562.
25. Cunningham-Myrie, C., et al., Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country. Tropical Medicine & International Health, 2013. 18(11): p. 1365-1378.
26. Weycker, D., et al., Excess risk of diabetes in persons with hypertension. Journal of Diabetes and its Complications, 2009. 23(5): p. 330-336.
27. Drivsholm, T., et al., Symptoms, signs and complications in newly diagnosed type 2 diabetic patients, and their relationship to glycaemia, blood pressure and weight. Diabetologia, 2005. 48(2): p. 210-214.
28. Nasri, H. and M. Rafieian-Kopaei, Metformin: Current knowledge. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2014. 19(7): p. 658-664.
29. Maric-Bilkan, C., Sex differences in micro- and macro-vascular complications of diabetes mellitus. Clinical Science, 2017. 131(9): p. 833-846.
30. Singh, S.S., et al., Sex difference in the incidence of microvascular complications in patients with type 2 diabetes mellitus: a prospective cohort study. Acta Diabetol, 2020. 57(6): p. 725-732.
31. Gedebjerg, A., et al., Prevalence of micro- and macrovascular diabetes complications at time of type 2 diabetes diagnosis and associated clinical characteristics: A cross-sectional baseline study of 6958 patients in the Danish DD2 cohort. J Diabetes Complications, 2018. 32(1): p. 34-40.
32. Aaberg, M.L., et al., Gender differences in the onset of diabetic neuropathy. Journal of Diabetes and its Complications, 2008. 22(2): p. 83-87.
33. Kamenov, Z.A., R.A. Parapunova, and R.T. Georgieva, Earlier development of diabetic neuropathy in men than in women with type 2 diabetes mellitus. Gender Medicine, 2010. 7(6): p. 600-615.
34. Booya, F., et al., Potential risk factors for diabetic neuropathy: a case control study. BMC Neurology, 2005. 5(1): p. 24.
35. Hicks, C.W. and E. Selvin, Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Current Diabetes Reports, 2019. 19(10): p. 86.
36. Collins, V.R., et al., High Prevalence of Diabetic Retinopathy and Nephropathy in Polynesians of Western Samoa. Diabetes Care, 1995. 18(8): p. 1140.
37. LaMonica, L.C., et al., The Soifua Manuia Telemedicine Eye Screening Program in a High-Risk Population of Samoans with Diabetes. Investigative Ophthalmology & Visual Science, 2019. 60(9): p. 1067-1067.
38. Grosso, A., et al., Hypertensive retinopathy revisited: some answers, more questions. British Journal of Ophthalmology, 2005. 89(12): p. 1646.
39. Singleton, J.R. and A.G. Smith, Neuropathy associated with prediabetes: what is new in 2007? Curr Diab Rep, 2007. 7(6): p. 420-4.
40. Stino, A.M. and A.G. Smith, Peripheral neuropathy in prediabetes and the metabolic syndrome. Journal of Diabetes Investigation, 2017. 8(5): p. 646-655.
41. Lamparter, J., et al., Prevalence and associations of diabetic retinopathy in a large cohort of prediabetic subjects: The Gutenberg Health Study. Journal of Diabetes and its Complications, 2014. 28(4): p. 482-487.
42. Diabetes Prevention Program Research, G., The prevalence of retinopathy in impaired glucose tolerance and recent-onset diabetes in the Diabetes Prevention Program. Diabetic Medicine, 2007. 24(2): p. 137-144.
43. Ballard, D.J., et al., Risk Factors for Diabetic Retinopathy: A Population-Based Study in Rochester, Minnesota. Diabetes Care, 1986. 9(4): p. 334.
44. Win Tin, S.T., et al., The prevalence of diabetes complications and associated risk factors in Pacific Islands countries. Diabetes Research and Clinical Practice, 2014. 103(1): p. 114-118.
45. Tuligenga, R.H., et al., Midlife type 2 diabetes and poor glycaemic control as risk factors for cognitive decline in early old age: a post-hoc analysis of the Whitehall II cohort study. The Lancet Diabetes & Endocrinology, 2014. 2(3): p. 228-235.
46. Kleefstra, N., et al., Cross-sectional relationship between glycaemic control, hyperglycaemic symptoms and quality of life in type 2 diabetes (ZODIAC-2). Neth J Med, 2005. 63(6): p. 215-21.
47. Schwartz, C.E. and M.A. Sprangers, Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Soc Sci Med, 1999. 48(11): p. 1531-48.
48. Sullivan, M.D., et al., Health-Related Quality of Life and Cost-Effectiveness Components of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial: Rationale and Design. The American Journal of Cardiology, 2007. 99(12, Supplement): p. S90-S102.
49. Wieringa, T.H., et al., Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics. BMJ open diabetes research & care, 2020. 8(1): p. e001146.
50. Hardin, J., “Healing is a Done Deal”: Temporality and Metabolic Healing Among Evangelical Christians in Samoa. Medical Anthropology, 2016. 35(2): p. 105-118.
51. Weaver, L.J. and E. Mendenhall, Applying Syndemics and Chronicity: Interpretations from Studies of Poverty, Depression, and Diabetes. Medical Anthropology, 2014. 33(2): p. 92-108.
52. Quillen, D.A., Common causes of vision loss in elderly patients. Am Fam Physician, 1999. 60(1): p. 99-108.
53. Schwarz, R., O. Krauss, and A. Hinz, Fatigue in the General Population. Oncology Research and Treatment, 2003. 26(2): p. 140-144.
54. Yu, T., et al., Retinopathy in Older Persons Without Diabetes and Its Relationship to Hypertension. Archives of Ophthalmology, 1998. 116(1): p. 83-89.
55. Vicario, A., et al., Hypertension and Cognitive Decline: Impact on Executive Function. The Journal of Clinical Hypertension, 2005. 7(10): p. 598-604.
56. Mier, N., et al., Health-related quality of life in a binational population with diabetes at the Texas-Mexico border. Rev Panam Salud Publica, 2008. 23(3): p. 154-63.
57. Adriaanse, M.C., et al., Diabetes-related symptoms and negative mood in participants of a targeted population-screening program for type 2 diabetes: The Hoorn Screening Study. Qual Life Res, 2005. 14(6): p. 1501-9.
58. Ciechanowski, P.S., et al., The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes. Gen Hosp Psychiatry, 2003. 25(4): p. 246-52.
59. Ludman, E.J., et al., Depression and diabetes symptom burden. Gen Hosp Psychiatry, 2004. 26(6): p. 430-6.
60. Wieringa, T.H., et al., Improving interpretability of individual Diabetes Symptom Checklist-Revised (DSC-R) scores: the role of patient characteristics. BMJ Open Diabetes Res Care, 2020. 8(1).
61. Kalra, S., Y.P.S. Balhara, and A. Mithal, Cross-cultural variation in symptom perception of hypoglycemia. Journal of mid-life health, 2013. 4(3): p. 176-181.
62. Melby, M.K., M. Lock, and P. Kaufert, Culture and symptom reporting at menopause. Hum Reprod Update, 2005. 11(5): p. 495-512.
63. Park, J. and M.E. Johantgen, A Cross-Cultural Comparison of Symptom Reporting and Symptom Clusters in Heart Failure. Journal of Transcultural Nursing, 2016. 28(4): p. 372-380.
64. Kirk, J.K., et al., Diabetes symptoms and self-management behaviors in rural older adults. Diabetes Research and Clinical Practice, 2015. 107(1): p. 54-60.
65. Barko, R., et al., Perceptions of Diabetes Symptoms and Self-Management Strategies: A Cross-Cultural Comparison. Journal of Transcultural Nursing, 2011. 22(3): p. 274-281.
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Associations between diabetes-related symptoms, glycemic control, and health-related quality of life in adult Samoans: Diabetes-related symptoms in adult Samoans. PacHealthDialog [Internet]. 2022 Dec. 20 [cited 2025 Oct. 29];21(10):638-55. Available from: https://www.pacifichealthdialog.nz/index.php/phd/article/view/127
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How to Cite
1.
Associations between diabetes-related symptoms, glycemic control, and health-related quality of life in adult Samoans: Diabetes-related symptoms in adult Samoans. PacHealthDialog [Internet]. 2022 Dec. 20 [cited 2025 Oct. 29];21(10):638-55. Available from: https://www.pacifichealthdialog.nz/index.php/phd/article/view/127