AbstractAim. The purpose of this st

Abstract
Aim. The purpose of this study was to examine the mediating influence of
diabetes health characteristics (diabetes distress, depression symptoms and
diabetes symptoms) on the relationship between glucose control and fatigue in
adults with type 2 diabetes.
Background. In patients with type 2 diabetes, fatigue is common and can affect
diabetes self-management behaviours. Although long thought to result from
hyperglycaemia, little evidence supports a relationship between fatigue and
glucose control.
Design. A cross-sectional, descriptive study design was used.
Method. Data were combined from two studies conducted at a large urban
university in the Midwestern United States, resulting in a total sample of 155
urban-dwelling adults with type 2 diabetes. Data were collected over the course
of 6 days from 2013–March 2014. Fatigue and related biological and
psychological phenomena were measured to perform path analyses using
structural equation modelling methods. The STATA software was used to analyse
the data.
Findings. In patients with A1C less than or equal to 7%, fatigue was related to
diabetes distress and diabetes symptoms, but not to A1C directly or indirectly. In
the group with A1C greater than 7%, fatigue was indirectly related to A1C; this
relationship was mediated through diabetes symptoms, depression and diabetes
distress.
Conclusion. Our findings suggest that fatigue is indirectly related to glucose
control, but only in patients who have elevated A1C levels. In those with adequate
glucose control, fatigue is mainly influenced by the presence of diabetes symptoms
and distress. In both groups, the number and severity of diabetes symptoms were
the strongest predictors of fatigue, regardless of blood glucose control.