Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Roberta Lavin


Roxanne Vandermause

Anne Fish

Deborah Fritz


This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran and non-veteran subsamples, as well as determine the influence of distress and social support in the presence the established risk factors of age, BMI, and genetic risk for diabetes.

The average subject’s hemoglobin A1c (HbA1c) was 8.3%, BMI was 34.1, ESSI score was 15, and RLCQ score was 297.6 LCU. Twenty-nine subjects were diagnosed with a mental illness. Age and BMI had significant influence on the development of T2DM for the sample (β=-.241, p=.031 and β=-.293, p=0.10, respectively) while distress was not significant (β=-.040, p=.721). The mean HbA1c for the subgroups were significantly different (t=2.768, p=.007) The differences in age, BMI (t=-1.158, p=.250), GRD (t=-1.279, p=.206), and RLCQ scores (t=-.487, p=.628) were not significantly different.