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The role of diabetes related distress in the association between body mass index and physical activity in Type 2 Diabetes Mellitus: A mediator-moderator analysis

The association between obesity and glycaemic control Type 2 Diabetes Mellitus (T2DM) has been well established. Furthermore, diabetes related distress is more prevalent among people with T2DM. However, the role of diabetes related distress in the association between obesity and glycaemic control is currently unclear. Therefore, we have planned to perform both mediator and moderator analyses to determine the exact role of diabetes related distress in the association between obesity and glycaemic control in people with T2DM. Specifically, we sought to determine if diabetes related distress moderates the effect of obesity on glycaemic control. We also sought to determine if diabetes related distress itself, mediates the association between obesity and glycaemic control.
Understanding how the relationship between obesity and glycaemic control is affected by diabetes related distress, not only may shed light on the underlying mechanisms, but potentially helps identify ways to improve the glycaemic control among this population cohort. Specifically, if diabetes related distress affects this relationship, it may be an important marker for identifying high-risk individuals, and could lead to preventative strategies.
Ethical approval has already been granted for this project and database collection for this moderator-mediator analysis has already started. This project will use causal inference and regression modelling techniques to provide potential explanation to a clinical question.