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Age Differences in Hopelessness and Toe Pain in Persons with Insulin-Dependent and Non-Insulin-Dependent Diabetes Mellitus

Stephen Morewitz Department of Nursing and Health Sciences, California State University, East Bay, Oakland, CA.

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Najwa Javed Veterans Affairs, Palo Alto, CA.

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Sharada Tata California State University, East Bay, San Francisco, CA.

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Joel Clark Department of Podiatric Surgery, California School of Podiatric Medicine at Samuel Merritt University, San Francisco, CA.

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Background: Several studies have established an association between diabetic neuropathy and depressive symptoms. There is a link between depression and peripheral neuropathy in diabetic patients, suggesting an increased likelihood that diabetic patients will experience depressive symptoms related to lower-extremity peripheral neuropathy and arthritis during middle age and later life. The goal of this investigation was to determine whether there are age differences between insulin-dependent and non-insulin-dependent diabetic patients regarding their feelings of hopelessness and toe pain.

Methods: A large population-based sample of 32,006 adults from the 1998 National Health Interview Survey was analyzed with multivariate statistical procedures. We performed χ2 and correlation procedures to test the null hypothesis that there are no age or sex differences between insulin-dependent and non-insulin-dependent diabetic patients in their reporting of feelings of hopelessness and toe pain symptoms in the previous 12 months.

Results: There were significant differences between age and sex groups of insulin-dependent and non-insulin-dependent diabetic patients in reporting feelings of hopelessness and toe pain symptoms, rejecting the null hypothesis. Correlational analysis conducted between the variables of hopelessness and toe pain yielded significant correlations in insulin-dependent (r = .28; P = .0009; α = .05), and non-insulin-dependent (r = 0.19; P = .001; α = .05) women older than 61 years, concluding that diabetic women are more likely to experience hopelessness and toe pain in that age group regardless of insulin status.

Conclusions: Clinicians should incorporate depression and toe pain symptoms into their assessment and treatment, especially in diabetic women older than 61 years. (J Am Podiatr Med Assoc 100(6): 445–451, 2010)

Corresponding author: Sharada Tata, MS, California State University, East Bay, 695 Noe St, Ste 1, San Francisco, CA 94114. (E-mail: sharadatata@yahoo.com)