Journal
DIABETIC MEDICINE
Volume 33, Issue 12, Pages 1632-1639Publisher
WILEY
DOI: 10.1111/dme.13105
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Funding
- European Regional Development Fund via OP-Zuid
- Province of Limburg
- Dutch Ministry of Economic Affairs [31O.041]
- Stichting De Weijerhorst (Maastricht, the Netherlands)
- Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
- Cardiovascular Center (CVC, Maastricht, the Netherlands)
- Cardiovascular Research Institute Maastricht (CARIM, Maastricht, the Netherlands)
- School for Public Health and Primary Care (CAPHRI, Maastricht, the Netherlands)
- School for Nutrition, Toxicology and Metabolism (NUTRIM, Maastricht, the Netherlands)
- Stichting Annadal (Maastricht, the Netherlands)
- Health Foundation Limburg (Maastricht, the Netherlands)
- Janssen-Cileg B.V. (Tilburg, the Netherlands)
- Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands)
- Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)
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AimsTo determine the association of verbal intelligence, a core constituent of health literacy, with diabetic complications and walking speed in people with Type 2 diabetes. MethodsThis study was performed in 228 people with Type 2 diabetes participating in the Maastricht Study, a population-based cohort study. We examined the cross-sectional associations of score on the vocabulary test of the Groningen Intelligence Test with: 1) determinants of diabetic complications (HbA(1c), blood pressure and lipid level); 2) diabetic complications: chronic kidney disease, neuropathic pain, self-reported history of cardiovascular disease and carotid intima-media thickness; and 3) walking speed. Analyses were performed using linear regression and adjusted in separate models for potential confounders and mediators. Significant age- and sex-adjusted associations were additionally adjusted for educational level in a separate model. ResultsAfter full adjustment, lower verbal intelligence was associated with the presence of neuropathic pain [odds ratio (OR) 1.18, 95% CI 1.02;1.36], cardiovascular disease (OR 1.14, 95% CI 1.01;1.30), and slower walking speed (regression coefficient -0.011 m/s, 95% CI -0.021; -0.002 m/s). These associations were largely explained by education. Verbal intelligence was not associated with blood pressure, glycaemic control, lipid control, chronic kidney disease or carotid intima-media thickness. ConclusionsLower verbal intelligence was associated with the presence of some diabetic complications and with a slower walking speed, a measure of physical functioning. Educational level largely explained these associations. This implies that clinicians should be aware of the educational level of people with diabetes and should provide information at a level of complexity tailored to the patient.
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