Fewer Type A personality traits in type 2 diabetes patients with diabetic foot ulcer?

Compelling data from Verges and coworkers from Dijon and coworkers that is certainly worthy of discussion.

Fewer Type A personality traits in type 2 diabetes patients with diabetic foot ulcer
Fig. 1. Histograms of: (A) Bortner Scale score distributions in type 2 diabetes (T2D) patients with (grey) and without (white) diabetic foot ulcer (DFU); (B) distribution of Bortner score quartiles in T2D patients with (grey) and without (white) DFU; and (C) prevalence of Bortner A and Bortner B personality types in T2D patients with (grey) vs without (white) DFU.


Aim. – Type A personality—characterized by time urgency, strong drive, and a need for achievement and competitiveness—has been shown to be associated with reduced mortality in patients with diabetes. However, it is not known whether a Type A personality might protect against diabetic foot ulcer (DFU). This prompted our present analysis of the association between Type A personality and DFU.

Methods. – The Bortner Scale questionnaire was used to assess Type A personality in 386 patients with type 2 diabetes (T2D), including 104 patients also presenting with, and 282 presenting without, DFU. Additional questionnaires were used to assess perceived stress and depression.

Results. – Type A Bortner scores were significantly lower in T2D patients with vs without DFU (166.64 ± 38.76 vs 178.79 ± 36.61, respectively; P = 0.005). In patients with DFU, the prevalence of Type A personality traits was significantly lower than in those without DFU (48% vs 64.5%, respectively; P = 0.005) whereas, in contrast, Type B personality traits (the opposite of Type A) were more prevalent (52% vs 35.5%, respectively; P = 0.005). On multivariate analysis, Type A Bortner scores were negatively associated with DFU (P = 0.008) independently of age, gender, BMI, depression scores or perceived stress.

Conclusion. – The Type A personality, characterized by competitiveness and a need for achievement, is significantly less frequently seen in T2D patients with DFU. On the other hand, the Type B personality is much more prevalent in such patients. It may be that the Type B personality, which is characterized by fewer problem-focused coping strategies and a decreased adherence to care, might favour the development of DFU.

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