Long-term course and predictors of pain and severe fatigue in Type 1 diabetes

Abstract

Background: Severe fatigue is a common symptom in patients with type 1 diabetes (T1D). A previous study found a prevalence rate of 40%. Little is known about the long-term course of fatigue in T1D. Methods: This longitudinal study with two assessments investigated the long-term course and possible predictors of fatigue. At baseline 214 T1D patients participated. They filled in questionnaires regarding fatigue severity, pain and cognitive-behavioural factors known to be associated with fatigue. Three years later 190 patients participated again. Multiple regression analysis was used to determine predictors of fatigue. Findings: The prevalence of fatigue was 40% at baseline and 42.5% at follow-up. About 75% of the patients, who were fatigued at baseline, were also severely fatigued at follow-up. Fatigue severity at follow-up was predicted by somatic complications and diabetes- and fatigue-related cognitions. Pain predicted fatigue at baseline, but not at follow-up. Discussion: Severe fatigue is a highly prevalent and persistent symptom in T1D. Aside from somatic complications, cognitive-behavioural factors predict fatigue severity. This suggests that behavioural interventions may be of use in the management of T1D fatigue.