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Abstract
Purpose: This meta-analysis was conducted to determine the prevalence and risk factors of fatigue in type 1 and type 2 diabetes mellitus (DM).
Methods: Observational studies reporting the prevalence and risk factors of fatigue in type 1 or 2 DM were systematically searched for in PubMed, Embase, CINAHL Plus, Cochrane Trial, and ProQuest Dissertation and Theses databases. Data were extracted by two independent reviewers. A random-effect model was used for data analysis.
Findings: We included 19 studies involving 7131 patients with type 1 DM and 32 studies involving 34,994 patients with type 2 DM in the study. The pooled prevalence of fatigue in type 1 and type 2 DM was 44% and 50%, respectively. The Asia-Pacific region (e.g., Japan and Australia), South America, and Africa lacked reports regarding fatigue prevalence in type 1 DM, and North Asia and Southeast Asia lacked reports of fatigue prevalence in type 2 DM. Depression and physical activity were the only two variables significantly correlated with fatigue in both type 1 and type 2 DM (all p < 0.05).
Conclusions: Approximately half of the patients with type 1 or type 2 DM experienced fatigue, with the prevalence of 44% and 50%, respectively. Our findings regarding its risk factors can provide an evidence-based approach for managing fatigue in DM patients.
Clinical relevance: This meta-analysis emphasizes the importance of fatigue management in patients with type 1 and type 2 DM. Most significantly, our results on risk factors related to fatigue in diabetes can contribute to the development of evidence-based strategies for managing fatigue in individuals with DM.
KEYWORDS
diabetes, fatigue, meta-analysis, prevalence, risk factor
INTRODUCTION
Diabetes mellitus (DM) is a major worldwide public health concern (Saeedi et al., 2019). Fatigue is a common symptom of DM that may occur even after glycemic control. Fatigue in diabetes is defined as a subjective perception of physical or mental exhaustion (Aaronson et al., 1999) that can be triggered by lifestyle, medical, psychological, glycemia-related, and diabetes-related factors (Kalra & Sahay, 2018). Fatigue is associated with overweight (Singh et al., 2016), inflammation (Lasselin et al., 2012), glycemic variability (Griggs & Morris, 2018), insufficient diabetes self-care ability (Fritschi & Quinn, 2010), sleep problems (Goedendorp et al., 2014), reduced quality of life, and impaired functional status (Singh...