Setbacks in diet adherence and emotional distress: a study of older patients with type 2 diabetes and their spouses

Aging Ment Health. 2012;16(7):902-10. doi: 10.1080/13607863.2012.674486. Epub 2012 Apr 26.


Objectives: We investigated patients' difficulties in managing their diet (i.e. diet setbacks) and associations with change in disease-specific and general emotional distress (diabetes distress and depressive symptoms) among patients with type 2 diabetes and their spouses.

Method: Data for this study were collected in couples' homes (N=115 couples) using structured interviews and self-administered questionnaires at three time points: baseline (T1), six months after baseline (T2) and 12 months after baseline (T3).

Results: Patients' diet setbacks were associated with an increase in their diabetes distress in the shorter-term (over six months). Patients' diet setbacks were not associated with longer-term change in diabetes distress or with change in depressive symptoms at either time point (six months or one year). In contrast, spouses' perceptions of patients' diet setbacks were associated with increases in their own diabetes distress at both time points (over six months and one year), and also with an increase in their depressive symptoms in the longer-term (over one year).

Conclusion: Findings reveal detrimental consequences of patients' diet nonadherence for emotional well-being that extend to the well-being of their spouses.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2 / nursing*
  • Diabetes Mellitus, Type 2 / psychology*
  • Diet*
  • Female
  • Guideline Adherence
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Self Care*
  • Spouses / psychology*
  • Stress, Psychological*