Predictors of psychological well-being in Types 1 and 2 diabetes

Psychological well-being and individuals representations of their illness were assessed for 96 patients with Type 1 diabetes and 139 patients with Type 2 diabetes who attended a hospital diabetic clinic for an annual check-up. Metabolic control (HbA1c) and the presence of diabetic complications (retinopathy, neuropathy, hypertension and nephropathy) were also recorded. Type 2 patients, as expected, tended to be older and be experiencing more complications than Type 1 patients. Consistent with previous findings, women reported lower well-being than men. Type 1 and Type 2 patients did not differ in terms of well-being, but the predictors of well-being were somewhat different in the two groups. In both groups, well-being was related to control beliefs (confidence in selfmanagement and ability to delay complications) and to lower ratings of the extent to which diabetes interfered with everyday activities. For Type 1 patients only, well-being also related to a tendency to perceive their diabetes as having minimal impact on their lives. Metabolic control showed no consistent relationship with psychological variables, but the number of complications significantly predicted lower well-being among Type 2 patients only. It is argued that well-being is a function both of illness representations and the actual experience of complications, which are more prevalent among those with Type 2 than Type 1 diabetes.