A theoretical framework to guide a study for exploring the impact of established and potential risk factors for type 2 diabetes mellitus

Aim: The purpose of this paper is to present the conceptual framework that was used to guide a study on the development of type 2 diabetes mellitus (T2DM). Background: The Stress and Coping Framework for Type 2 Diabetes Mellitus was developed in response to a review of the literature that suggests psychological stress, or simply distress, can contribute toward the development of T2DM with the established risk factors of genetic risk for diabetes (GRD), obesity, and advancing age. The literature shows that distress can influence insulin sensitivity and contribute to the development of T2DM; however, much of the literature fails to acknowledge the influence of distress in collaboration with GRD, obesity, and advancing age. Method: As part of creating the current framework, an earlier version of the conceptual framework was used for a pilot study. An integrative review was conducted to examine the relationships among GRD, obesity (as a response to weight management), advancing age, distress, and coping (as a response to distress) to further refine the conceptual framework. Theoretical and empirical studies were examined to define distress, describe the nature and impact of the stress response, and determine how distress interacts with GRD, obesity, and advancing age. The literature was used to create a conceptual framework and model consisting of the interactions among the variables. Conclusion: The Stress and Coping Framework for Type 2 Diabetes Mellitus shows how distress can contribute to the development of T2DM by interacting directly with established risk factors and in promoting insulin resistance.