Key result
Combined cardiometabolic abnormalities and high stress are linked to a ~52-fold higher risk of diabetes-related quality-of-life obstacles.
Why the study?
Diabetes-related quality of life is shaped by cardiometabolic dysfunction and psychological stress, but these mechanisms are rarely examined within a unified framework.
Do cardiometabolic abnormalities and psychological stress synergistically increase diabetes-related quality of life obstacles in adults with type 2 diabetes?
Cross-Sectional (n=1,815)
Yes
Do cardiometabolic abnormalities and psychological stress synergistically increase diabetes-related quality of life obstacles in adults with type 2 diabetes?
Odds Ratio: 52.097
Cardiometabolic dysfunction and psychological stress synergistically amplify obstacles to diabetes-related quality of life, highlighting the need for integrated bio-psycho-metabolic care.
Does not support practice changes in type 2 diabetes; leaves open causal confirmation via prospective studies.
BACKGROUND: Diabetes-related quality of life (DR-QoL) is shaped by interactions between cardiometabolic dysfunction and psychological stress, yet these mechanisms are rarely examined within a unified framework. AIMS: To evaluate the independent, interactive, and mediating effects of cardiometabolic factors and stress on DR-QoL obstacles. METHODS: A cross-sectional study was conducted among 1815 adults with type 2 diabetes from 15 Indonesian provinces (2023-2024). Stress and DR-QoL obstacles were assessed using validated instruments. Independent and synergistic effects were examined using logistic regression, and mediation was tested via path analysis. RESULTS: Overweight, obesity, stage 2 systolic hypertension, and abnormal fasting blood glucose (FBG) significantly predicted high stress (AOR = 1.982-20.889; p < 0.001), with synergistic interactions markedly amplifying the risk (AOR up to 53.972). DR-QoL obstacles were strongly associated with cardiometabolic abnormalities (AOR = 1.352-18.420) and high stress (AOR = 18.930), with the highest risk observed in participants with multiple concurrent abnormalities (AOR = 52.097). Mediation analysis identified FBG and stress as key mediators, with stress showing the strongest direct effect on DR-QoL obstacles (β = 0.397). LINKING EVIDENCE TO ACTION: These findings highlight FBG and stress as central mechanistic targets for interventions aimed at reducing DR-QoL obstacles.
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Fadlilah et al. (2026) conducted a cross-sectional in Type 2 diabetes (n=1,815). Cardiometabolic abnormalities and psychological stress vs. Absence of cardiometabolic abnormalities and low stress was evaluated on Diabetes-related quality of life (DR-QoL) obstacles (AOR 52.097). The concurrent presence of all measured cardiometabolic abnormalities and high stress was associated with a markedly increased risk of diabetes-related quality of life obstacles (AOR 52.097).
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