Fatigue in Adults with Type 2 Diabetes: An Integrative Review
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Introduction: People with type 2 diabetes mellitus (T2DM) experience various symptoms that are likely to worsen mental and physical well-being. Fatigue is one of the most prevalent and disturbing symptoms for adults with T2DM. This literature review 1) examined demographic, physiologic, and psychosocial factors related to fatigue, and 2) explored the associations among fatigue, diabetes self-management and quality of life (QoL) in adults with T2DM.Methods: We searched PubMed, PsycINFO, and CINAHL electronic databases for research articles that included a sample of adults with T2DM; were peer-reviewed, written in English; and investigated fatigue as a primary or secondary outcome. Two investigators independently appraised the quality of the studies and extracted the data.Results: Twenty-two articles met the inclusion criteria (representing n = 15,610 people): 17 observational studies, 2 randomized controlled trials, 1 quasi-experimental study, and 2 qualitative studies. All were of high quality. Most studies were conducted in the U.S. (n = 13); others were conducted in 9 other countries. Non-Hispanic White and Black were the most studied. Fatigue was measured using the Multidimensional Fatigue Inventory (n = 6) and 8 other measures. Demographic (e.g., age, sex, education, social support), physiological (e.g., T2DM duration, complications, inflammatory biomarkers), and psychological factors (e.g., diabetes distress, depression, sleep quality) were related to fatigue in adults with T2DM. Most studies examined physiological factors related to fatigue using a cross-sectional design. Fatigue was negatively associated with both diabetes self-management and QoL.Conclusion: Research demonstrates significant relationships between fatigue and self-management and QoL in adults with T2DM. Gaps in the literature include the trajectory of fatigue over time, effects of interventions (e.g., sleep interventions) to alleviate fatigue, and unique experiences of fatigue in under-represented populations.DisclosureH. Kuo: None. Y. Huang: None. A.A. Garcia: None.
