4.3 Article

Lower verbal intelligence is associated with diabetic complications and slower walking speed in people with Type 2 diabetes: the Maastricht Study

Journal

DIABETIC MEDICINE
Volume 33, Issue 12, Pages 1632-1639

Publisher

WILEY
DOI: 10.1111/dme.13105

Keywords

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Funding

  1. European Regional Development Fund via OP-Zuid
  2. Province of Limburg
  3. Dutch Ministry of Economic Affairs [31O.041]
  4. Stichting De Weijerhorst (Maastricht, the Netherlands)
  5. Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
  6. Cardiovascular Center (CVC, Maastricht, the Netherlands)
  7. Cardiovascular Research Institute Maastricht (CARIM, Maastricht, the Netherlands)
  8. School for Public Health and Primary Care (CAPHRI, Maastricht, the Netherlands)
  9. School for Nutrition, Toxicology and Metabolism (NUTRIM, Maastricht, the Netherlands)
  10. Stichting Annadal (Maastricht, the Netherlands)
  11. Health Foundation Limburg (Maastricht, the Netherlands)
  12. Janssen-Cileg B.V. (Tilburg, the Netherlands)
  13. Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands)
  14. 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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