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Neves NWT, Breder JSC, Oliveira BA, Zanchetta FC, Barreto J, Sposito AC, Lima MHM. Diabetes-related distress and quality of life among people with type 2 diabetes at primary care level in Brazil. Acta Diabetol 2024; 61:461-471. [PMID: 38095701 DOI: 10.1007/s00592-023-02216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/17/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE Living with diabetes can be challenging, particularly when it comes to dealing with psychological distress and requiring self-care directives. Patients may feel frustrated, angry, overwhelmed, and discouraged. This study aimed to investigate the diabetes-related distress and quality of life among people with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study carried out at the Clinical Research Centre at the University of Campinas, Brazil, between September 2020 and April 2021. Patients answered data regarding demographic and clinical variables, the Brazilian version of the Diabetes Distress Scale and the Diabetes Quality of Life (QOL) Measure by telephone contact. The data were managed using the RedCap System. For statistical analysis of the data, the Mann-Whitney and Kruskal-Wallis tests were applied for comparisons, and the Chi-square test for associations. The correlations were evaluated using the Spearman correlation coefficient. RESULTS Out of the 302 participants we recruited, 50.33% exhibited significant diabetes-related distress. Those with elevated diabetes-related distress scores had shorter education levels (p < 0.05), lower HbA1c levels (p < 0.05), and lower total scores in Diabetes QOL Measure (p < 0.0001), particularly in the QOL impact (p < 0.0001), social/vocational worry (p < 0.05), and diabetes worry (p < 0.0001) subscales compared to the group with the lowest diabetes-related distress. CONCLUSION Elevated diabetes-related stress scores significantly affect patients' QOL. Therefore, early screening of individuals at risk for this condition, using well-coordinated protocols, could mitigate adverse QOL effects and enhance their overall experience during disease management.
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Affiliation(s)
| | | | | | | | - Joaquim Barreto
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
| | - Andrei C Sposito
- Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, São Paulo, Brazil
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Hiasat DA, Salih MB, Abu Jaber AH, Abubaker OF, Qandeel YA, Saleem BA, Aburumman SI, Al-Sayyed ARH, Hussein TI, Hyassat D. The prevalence of diabetes distress among patients with type 2 diabetes in Jordan. J Taibah Univ Med Sci 2023; 18:1237-1243. [PMID: 37250811 PMCID: PMC10213091 DOI: 10.1016/j.jtumed.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/03/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives Diabetes distress (DD) is a state of emotional distress that evolves from living with chronic disease and the burden of daily adjustments of medications and lifestyle. This study investigated the prevalence of DD in patients with type 2 diabetes mellitus (T2DM) in Jordan and the related sociodemographic and medical factors. Methods We conducted a cross-sectional study in 608 patients with T2DM in Jordan, ranging from ages 15 to 80 years. The participants filled out a questionnaire where they were asked to self-assess their DD using the Diabetes Distress Scale. In all, 32 participants were excluded according to the exclusion criteria, which resulted in 576 people being included in this study. Results The overall prevalence of DD was 53% (25% had moderate distress and 28% had high distress). Emotional distress had the highest prevalence among the DD subscales, with a total prevalence of 58.8%. The data showed a significant association of DD with different factors including age, the presence of diabetic complications, the type of medication used, and medication adherence. Conclusion This study showed a high prevalence of DD (53%). This finding should raise awareness to healthcare providers about the importance of screening for DD as part of the treatment guidelines, especially in patients who are on multiple medication regimens for DM; patients who have previous medical complications related to DM; and those who exhibit poor adherence to medications, which was found to be a risk factor of DD in this study.
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Affiliation(s)
- Duaa A. Hiasat
- Faculty of Medicine, Al-Balqa' Applied University, Jordan
| | | | | | | | | | | | | | | | | | - Dana Hyassat
- National Center for Diabetes, Endocrinology and Genetics, Jordan
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Factors associated with diabetes-related distress among Asian patients with poorly controlled type-2 diabetes mellitus: a cross-sectional study in primary care. BMC PRIMARY CARE 2023; 24:54. [PMID: 36849921 PMCID: PMC9969642 DOI: 10.1186/s12875-023-02012-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/20/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Diabetes-related distress (DRD) is a negative emotional state related to the burden of living with diabetes mellitus. It has been associated with poor self-care and glycaemic control. This cross-sectional study aimed to examine the factors associated with DRD among urban Asian patients with poorly controlled type-2 diabetes mellitus (T2DM) in primary care in Singapore. The factors included demographics, diabetes history, medical co-morbidities, mood disorders and social history. METHODS Patients with T2DM and HbA1c of 8% or more were recruited from 2 public primary care centres in Singapore. They were administered a questionnaire survey to identify DRD based on the Problem Area In Diabetes (PAID) scale. Their anxiety and depression were screened using GAD-7 and PHQ-9, and quality of life (QOL) measured using the EQ-5D-5L. Their clinical data, including HbA1c, comorbidities and medications, were extracted from the electronic medical records. RESULTS Among the 356 subjects, the prevalence of DRD was 17.4%. DRD was significantly associated with younger age (AOR (95% CI) = 0.93 (0.89-0.97), p = 0.001), ex-smoker status (AOR (95% CI) = 22.30 (2.43-204.71), p = 0.006) and history of kidney disease (AOR (95% CI) = 3.41 (1.39-8.35), p = 0.007). Those who screened positive for depression (AOR (95% CI) = 4.98 (1.19-20.86), p = 0.028) were almost five times more likely to have DRD. Quality of life was lower among those with DRD (EQ5D index score AOR (95% CI) = 0.11 (0.01-0.97), p = 0.047), who also tended to feel that diabetes pharmacotherapy interfered with their normal life (AOR (95% CI) = 2.89 (1.38-6.08), p = 0.005). CONCLUSION About 1 in 6 patients with poorly controlled T2DM had DRD. Younger age, ex-smoker status, history of kidney disease, and those with depressive symptoms were most at risk.
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Du Y, Baumert J, Paprott R, Färber F, Nübel J, Hermanns N, Heidemann C, Scheidt-Nave C. Diabetes-related distress and associated factors among adults with diabetes in Germany: Results of the nationwide study "Disease knowledge and information needs - Diabetes mellitus 2017". J Psychosom Res 2023; 164:111073. [PMID: 36370499 DOI: 10.1016/j.jpsychores.2022.111073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/30/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Diabetes-related distress (DRD) can affect diabetes management adversely. In lack of population-based data, the frequency and determinants of DRD among adults with diabetes in Germany remain controversial. METHODS This study included 1367 adults with diabetes who participated in a nationwide health telephone survey conducted among German adults aged 18 years and older in 2017. The short form of the Problem Areas in Diabetes (PAID-5) scale was used to assess DRD. The associations of high DRD (PAID-5 sum score ≥ 8) with socio-demographics, diabetes-related risk factors, diabetes clinical characteristics as well as quality of self-care and chronic illness care assessed by patients were tested in multivariable logistic regression models. RESULTS The overall DRD prevalence was 15.1% (95% confidence intervals, 95% CIs, 12.5-18.0%) with no significant difference between men (14.7%, 95% CIs 11.2-19.1%) and women (15.4%, 11.9-19.8%). In multivariable analyses, DRD was significantly associated with younger age (odds ratio 0.96, 95% CIs 0.94-0.98, per year), immigration background (2.26, 1.16-4.42), current smoking (2.06, 1.14-3.70), insulin use (2.57, 1.45-4.56), and the presence of diabetes-specific complications (1.80, 1.10-2.94) or depressive symptoms (5.34, 3.24-8.81). Among those with depressive symptoms (18,4% of the study population), 38.3% also had DRD, which accounted for 7.0% (95% CIs 5.3-9.3%) of the study population. CONCLUSION DRD is a common health problem among adults with diabetes in Germany, and highly correlates with depressive symptoms, current smoking, immigration background, and insulin use. Addressing DRD needs to become an integrative part of ambulatory diabetes care.
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Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Rebecca Paprott
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Francesca Färber
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Nübel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes-Academy Bad Mergentheim (FIDAM), Bad Mergentheim, Baden-Württemberg, Germany
| | - Christin Heidemann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christa Scheidt-Nave
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Sayed Ahmed HA, Mohamed SF, Mostafa M, Elotla SF, Shah A, Shah J, Fouad AM. Psychometric evaluation of the Arabic version of the 5-item Problem Areas in Diabetes (AR-PAID-5) scale. BMC PRIMARY CARE 2022; 23:148. [PMID: 35681150 PMCID: PMC9185861 DOI: 10.1186/s12875-022-01758-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/30/2022] [Indexed: 11/29/2022]
Abstract
Background Screening for diabetes distress is recommended when caring for patients with type 2 diabetes mellitus (T2DM) in primary healthcare (PHC). The 5-item Problem Areas in Diabetes (PAID-5) scale is widely used to measure diabetes distress, but its Arabic validation studies are scarce, so this study was carried to assess the psychometric properties of the Arabic version of the PAID-5 (AR-PAID-5) in Egyptian PHC patients with T2DM. Methods We conducted a cross-sectional study including 260 participants from six rural PHC settings in Ismailia governorate, Egypt. Internal consistency using Cronbach’s α and one-month test-retest reliability using intraclass correlation coefficient (ICC) were investigated. Confirmatory factor analysis (CFA) was used to evaluate the one-factor structure of the AR-PAID-5. Correlations of the AR-PAID-5 with the Arabic versions of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), 5-item World Health Organization Well-Being Index (WHO-5) scales and glycated hemoglobin (HbA1c) were investigated for supporting the convergent validity. Associations of the PAID-5 with sociodemographic, and clinical characteristics were assessed for demonstrating the discriminant validity. Criterion validity was also evaluated. Results There was a good internal consistency (α = 0.88) and a stable test-retest reliability (ICC = 0.74). The CFA confirmed the one-factor structure of the AR-PAID-5. Significant positive correlations existed between the AR-PAID-5 with diabetes distress evaluated by the Arabic version of the PAID (rho = 0.93, p < 0.001), depressive symptoms (PHQ-9) (rho = 0.56, p < 0.001), anxiety symptoms (GAD-7) (rho = 0.47, p < 0.001), emotional well-being (WHO-5) (rho = − 0.38, p < 0.001), and HbA1c (rho = 0.16, p = 0.003). A satisfactory discriminant validity, and an acceptable criterion validity were demonstrated. Conclusions The AR-PAID-5 scale is a reliable and valid tool that can be used for diabetes distress screening and in research in Arabic speaking PHC patients with T2DM.
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Kintzoglanakis K, Gkousiou A, Vonta P, Sagmatopoulos A, Copanitsanou P. Depression, anxiety, and diabetes-related distress in type 2 diabetes in primary care in Greece: Different roles for glycemic control and self-care. SAGE Open Med 2022; 10:20503121221096605. [PMID: 35600704 PMCID: PMC9118887 DOI: 10.1177/20503121221096605] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/05/2022] [Indexed: 12/28/2022] Open
Abstract
Objectives: The psychological distress of people living with diabetes is increased and associated with poorer glycemic outcomes and self-care. We aimed to examine the frequency of depression, anxiety, and diabetes-related distress (DRD) of individuals with type 2 diabetes (T2D) in primary care (PC) and their comparative associations with clinical, self-care, and socio-demographic characteristics, testing for possible different roles on glycemic control and self-care. Methods: This is a cross-sectional study of 182 adults with a T2D diagnosis of at least six months, recruited between August 2019-March 2020 and May-October 2020, from an urban PC unit. Participants were screened for symptoms of depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder-7 (GAD-7)), and DRD (Diabetes Distress Scale (DDS)). Clinical, self-care, and socio-demographic parameters were recorded. Results: The frequency of clinically significant symptoms of depression was 16.6%, (PHQ-9 score ⩾10), anxiety 17.7% (GAD-7 score ⩾10), and DRD 22.6% (DDS score ⩾2). All PHQ-9, GAD-7, and DDS scores intercorrelated, and higher scores were found to be associated with female gender, lower income, and prior diagnosis of depression. Higher PHQ-9 and GAD-7 scores were found to be associated with lower education, more hypoglycemia episodes, more blood glucose self-tests and antidepressant or benzodiazepine use. The retired/housewives scored significantly lower in GAD-7 and DDS compared to the unemployed participants. Higher DDS scores were associated with higher glycated hemoglobin, higher fasting plasma glucose, and insulin use. It was also noted that higher PHQ-9 scores were associated with lower uric acid levels and were significantly higher in the sedentary lifestyle group. Conclusion: DRD was associated with poorer glycemic outcomes while depressive symptoms were associated with lower physical activity perhaps sharing different roles for glycemic control and self-care. The psychological burden of individuals with T2D may be considered in PC.
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Affiliation(s)
| | | | | | | | - Panagiota Copanitsanou
- General Hospital of Piraeus “Tzaneio,” Piraeus, Greece
- Department of Nursing Science, National and Kapodistrian University of Athens, Athens, Greece
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Sayed Ahmed HA, Fouad AM, Elotla SF, Joudeh AI, Mostafa M, Shah A, Shah J, Mohamed SF. Prevalence and Associated Factors of Diabetes Distress, Depression and Anxiety Among Primary Care Patients With Type 2 Diabetes During the COVID-19 Pandemic in Egypt: A Cross-Sectional Study. Front Psychiatry 2022; 13:937973. [PMID: 35722556 PMCID: PMC9203894 DOI: 10.3389/fpsyt.2022.937973] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) is growing worldwide. T2DM is often complicated by a range of psychological disorders that interfere with glycemic control and self-care. Previous studies have reported diabetes distress, depression, and anxiety among patients with T2DM; however; little is known about the burden of these comorbid mental disorders in primary care patients with T2DM treated in Egypt during the COVID-19 era. Participants were selected by convenient sampling from eight rural primary healthcare facilities from Ismailia in Egypt. Symptoms of diabetes distress, depression and anxiety were assessed by using the Arabic version of the 20-item Problem Areas in Diabetes (PAID), Patient Health Questionnaire 9, and Generalized Anxiety Disorder Scales, respectively. Multiple hierarchical logistic regression models were used to estimate the significant factors associated with diabetes distress, depression, and anxiety. A total of 403 individuals with T2DM were interviewed. The prevalence of severe diabetes distress was 13.4% (95% CI: 10.1-16.7), while prevalence of depressive and anxiety symptoms was 9.2% (95% CI: 6.4-12.0%), and 4.0% (95% CI: 2.1-5.9), respectively. In a series of hierarchical logistic regression models, significant predictors for diabetes distress were being married, illiterate, not-working, living with insufficient income, and having multi-comorbidities. Likewise, the significant predictors for depression and anxiety were elevated glycated hemoglobin level and the higher PAID total score, while having multi-comorbidities was a significant predictor for anxiety only. Diabetes distress was more prevalent than depressive and anxiety symptoms in this study population. Several sociodemographic and clinical characteristics were identified to be related with psychological problems among patients with T2DM, which necessitate a multidisciplinary team-based approach for optimal screening and management.
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Affiliation(s)
- Hazem A Sayed Ahmed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed Mahmoud Fouad
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Sally Fawzy Elotla
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Anwar I Joudeh
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.,Department of Internal Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Mona Mostafa
- Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Asghar Shah
- Division of Biology and Medicine, Brown University, Providence, RI, United States
| | - Jaffer Shah
- Medical Research Center, Kateb University, Kabul, Afghanistan
| | - Samar F Mohamed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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AlOtaibi AA, Almesned M, Alahaideb TM, Almasari SM, Alsuwayt SS. Assessment of diabetes-related distress among type 2 diabetic patients, Riyadh, Saudi Arabia. J Family Med Prim Care 2021; 10:3481-3489. [PMID: 34760777 PMCID: PMC8565154 DOI: 10.4103/jfmpc.jfmpc_488_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the prevalence of diabetes-related distress (DRD) among Type 2 diabetics in the diabetic center of King Salman Hospital, Riyadh, Saudi Arabia. METHODS This was an observational descriptive study conducted between December 2019 and January 2020 among T2DM patients followed up at the diabetic clinics of the Diabetic Center of King Salman Hospital in Riyadh, Saudi Arabia. We used the 17-items Diabetes Distress Scale (DDS17) to measure DRD. RESULTS A total of 399 T2DM patients were included in the study, 58.4% were males. High distress was seen in 40 patients. Multivariate analysis showed that longer duration of diabetes (>15 years), female gender, longer intervals in-between visits (>6 months), and experience of episodes of severe hypoglycemia as the most significant factors related to higher levels of distress. The patients who were diabetics longer than 15 years had an increased risk for high distress by 3.6 times, infrequent clinic visits (longer than 6 months) increased the risk for high distress by 5.3 times×, and patients who experienced severe hypoglycemia had an increased risk for high distress by 5.8 times. CONCLUSION This study showed a high (35.6%) prevalence of moderate to severe DRD. Long-standing diabetes, a longer interval of a clinic visit, and severe hypoglycemia increase the risk for DRD by 3.6, 5.3, and 5.8 folds. Health care providers should focus on reducing DRD and devise ways to increase self-care practices and coping skills.
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Affiliation(s)
- Abdullah Aedh AlOtaibi
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohammed Almesned
- Head Department of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Turki Mohammed Alahaideb
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saad Mohammed Almasari
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saleh Saad Alsuwayt
- Family Medicine Physicians, Academy of Family Medicine, King Saud Medical City, Riyadh, Saudi Arabia
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Niroomand M, Babaniamansour S, Aliniagerdroudbari E, Golshaian A, Meibodi AM, Absalan A. Distress and depression among patients with diabetes mellitus: prevalence and associated factors: a cross-sectional study. J Diabetes Metab Disord 2021; 20:141-151. [PMID: 34178826 PMCID: PMC8212327 DOI: 10.1007/s40200-020-00721-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/20/2020] [Accepted: 12/28/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE This study aimed to validate the internal consistency of the Persian version of the diabetes distress scale-17 (DDS-17) and to investigate the prevalence of diabetes distress (DD), depression, and possible relevant factors. METHODS This was a cross-sectional study on 820 diabetes patients (62.4 % females) in Tehran, Iran between January and June 2017. The Ethics Committee of Shahid Beheshti University of Medical Sciences approved the protocol. Patients filled out a demographic and health survey, DDS-17, the Beck Depression Inventory Second Edition (BDI-II) and the Summary of Diabetes Self-Care Activities Measure (SDSCA). DDS-17 consist of emotional burden, and physician, regimen, and interpersonal related distress. The correlation between DDS subscales and association between DDS and BDI-II or SDSCA scores were assessed using SPSS. RESULTS The mean age was 58.91 ± 12.35 years. Majority of patients had high DD (37.2 %) and severe depression (38.7 %). The general and specific diets got the highest score in six SDSCA subscales. The Persian version of DDS-17 had excellent internal consistency with Cronbach's alpha coefficient of 0.924. The DDS score had significant relationship with socioeconomic level (p < .001), type of DM (p < .001), type of treatment (p < .001), glycemic control status (p < .001), complication (p < .001) and depression level (p < .001). The level of hemoglobin A1c was the most useful predictor of DDS score (p < .001). CONCLUSIONS High prevalence of depression and distress in patient with diabetes calls for greater emphasizes on the importance of enhanced physicians and patients' knowledge in these areas.
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Affiliation(s)
- Mahtab Niroomand
- Division of Endocrinology, Department of Internal Medicine, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, 7th Floor, Bldg. No 2, Tehran, Iran
| | - Sepideh Babaniamansour
- Department of Internal Medicine, School of Medicine, Islamic Azad University Tehran Faculty of Medicine, Tehran, Iran
| | - Ehsan Aliniagerdroudbari
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Golshaian
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Abdorrahim Absalan
- Department of Clinical Laboratory Sciences, Khomein Faculty of Medical Sciences, Markazi, Iran
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Kuniss N, Kramer G, Müller UA, Wolf G, Kloos C. Diabetes related distress is high in inpatients with diabetes. Diabetol Metab Syndr 2021; 13:40. [PMID: 33836823 PMCID: PMC8034190 DOI: 10.1186/s13098-021-00659-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/29/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of the present study was to assess diabetes-related distress in inpatients and its association with metabolic control in people with diabetes type 1 (DM1) and type 2 (DM2). RESEARCH DESIGN AND METHODS In a cross-sectional study, 107 inpatients with DM1 (age 45.9 years, diabetes duration 18.7 years, HbA1c 8.4%/67.8 mmol/mol) and 109 with DM2 (age 62.0 years, diabetes duration 16.2 years, HbA1c 8.9%/74.3 mmol/mol) from a University department for endocrinology and metabolic diseases (Germany) were included over 2 years. Diabetes-related distress was assessed with the PAID questionnaire (range 0-100, higher scores imply higher diabetes-related distress, cut-off ≥ 40). The PAID questionnaire was completed by 214 of 216 participants. RESULTS Fifty-one of 214 individuals (23.8%) showed high distress (PAID score ≥ 40). The mean PAID score was 28.1 ± 17.5 in all participants with no difference between DM1 and DM2 (28.1 ± 17.4 vs. 26.2 ± 16.9, p = 0.532). Individuals with DM2 on insulin scored higher than patients without insulin (27.8 ± 17.6 vs. 18.7 ± 8.5, p = 0.004). Additionally, people with DM1 treated with a system for continuous glucose monitoring (n = 50, 33.1 ± 18.8) scored higher than participants without such system (n = 32, 20.6 ± 13.3, p = 0.001). HbA1c was not correlated with the PAID score in both, DM1 (r = 0.040, p = 0.684) and DM2 (r = - 0.024, p = 0.804). Participants with DM2 and severe hypoglycaemia/last 12 months scored higher than people without (PAID score 43.0 ± 20.4 vs. 25.1 ± 16.5, p = 0.026). Frequency of non-severe hypoglycaemia was not associated with the PAID score in DM1 and DM2. CONCLUSIONS Patients with diabetes treated in hospital for problems with diabetes suffer frequently from diabetes-related distress (~ 24%) regardless of diabetes type.
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Affiliation(s)
- Nadine Kuniss
- Department of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
- Outpatient Healthcare Centre Dr. med. Kielstein, Erfurt, Germany.
| | - Guido Kramer
- Department of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Ulrich A Müller
- Outpatient Healthcare Centre Dr. med. Kielstein, Erfurt, Germany
| | - Gunter Wolf
- Department of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Christof Kloos
- Department of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
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Nguyen VB, Tran TT, Dang TL, Nguyen VVH, Tran BT, Le CV, Toan ND. Diabetes-Related Distress and Its Associated Factors Among Patients with Diabetes in Vietnam. Psychol Res Behav Manag 2020; 13:1181-1189. [PMID: 33363418 PMCID: PMC7754255 DOI: 10.2147/prbm.s285291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/24/2020] [Indexed: 12/01/2022] Open
Abstract
Background Psychometric properties are regarded as one of the significant contributors related to diabetes treatment efficacy. Diabetes-related distress (DD) is one of the emotional burdens. The aims of this study were to investigate the prevalence of DD and to determine its associated factors among Vietnamese diabetic patients. Methods A cross-sectional study was conducted at a single medical center in the central of Vietnam. A total of 138 eligible DM outpatients were invited and a total of 112 patients who completed the questionnaire were utilized in this analysis using convenience sampling. DD was assessed using the diabetes distress scale (DDS). The participant’s sociodemographic and clinical information was obtained through face-to-face interviews and medical records. Multivariate logistic regression was used to determine independent factors associated with the presence of DD. Results Approximately, 12.5% of the patients experienced DD based on DDS self-administered questionnaire. The rates of mild/moderate and high distress were 8.0% and 4.5%, respectively. DD was found to be significantly higher in type 1 DM (p=0.04), insulin only in treatment regime (p=0.04), physical inactivities (p=0.02), times of mild hypoglycemia (time/month) (p=0.01), and fasting plasma glucose (mmol/l) (p=0.04). The occurrence of distress among DM patients was negatively correlated with their age and amount of physical exercise. Meanwhile, poor HbA1c control (HbA1c≥7%) was associated with an increased occurrence of diabetes distress. Conclusion The findings of single medical center in Vietnam highlights that DD is prevalent among DM patients. It should be of marked concerns, particularly the type 1 diabetic patients, younger age, and poor glycemic control patients.
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Affiliation(s)
- Van Bang Nguyen
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Tam Thi Tran
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Thi Ly Dang
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Van Vy Hau Nguyen
- Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam
| | - Binh Thang Tran
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Chi Van Le
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Nguyen Dinh Toan
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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12
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Kintzoglanakis K, Vonta P, Copanitsanou P. Diabetes-Related Distress and Associated Characteristics in Patients With Type 2 Diabetes in an Urban Primary Care Setting in Greece. CHRONIC STRESS 2020; 4:2470547020961538. [PMID: 33029569 PMCID: PMC7522819 DOI: 10.1177/2470547020961538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/06/2020] [Indexed: 11/27/2022]
Abstract
Background Diabetes-related distress (DRD) is a common psychological issue of people living with diabetes. International guidelines advise to take DRD into consideration in diabetes care but evidence for Greece is scarce. In the present study we aimed to estimate the frequency of DRD as assessed by Diabetes Distress Scale (DDS) and to examine its connections with clinical and sociodemographic characteristics among patients with type 2 diabetes mellitus (T2D) in urban primary care (PC) in Greece. Methods This descriptive survey included adults with a diagnosis of T2D of at least six months under medication treatment attending a novel, public urban PC unit. Patients with other forms of diabetes, dementia, and psychosis were excluded. Patients were screened for DRD with DDS instrument and correlations were made between DRD and clinical and sociodemographic characteristics. Results In 135 eligible participants the frequency of moderate to high levels of DRD (DDS ≥ 2) was 24.4% and of high levels of DRD (DDS ≥ 3) was 7.4%. Emotional burden (EB) subscale was significantly correlated with younger age, insulin use, duration of insulin use, and the number of insulin injections per day. Longer diabetes duration showed significant correlation with DDS total, EB, and regimen distress. Participants with lower income, sedentary lifestyle, micro-vascular complications, more episodes of hypoglycaemia, and higher levels of glycated haemoglobin (HbA1c) experienced significantly higher distress. Conclusion DRD screening is important in urban PC and in more susceptible patients as those on more insulin injections per day, with longer diabetes duration, higher levels of HbA1c, lower income, sedentary lifestyle, and more episodes of hypoglycaemia.
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Affiliation(s)
| | | | - Panagiota Copanitsanou
- General Hospital of Piraeus "Tzaneio", Piraeus, Greece.,Department of Nursing Science, National and Kapodistrian University of Athens, Athens, Greece
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13
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Type 2 Diabetes Mellitus Related Distress in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072329. [PMID: 32235629 PMCID: PMC7177402 DOI: 10.3390/ijerph17072329] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 12/12/2022]
Abstract
This study aimed to investigate prevalence and factors potentially associated with diabetes-related distress (DRD) among type 2 diabetes mellitus (T2DM) patients in a primary health care center in Thailand. This cross-sectional study was conducted with a total of 370 patients with T2DM. Data were collected at primary health care centers in Hang Dong District, Chiang Mai Province, Thailand. DRD was assessed using the Diabetes Distress Scale (DDS-17). The association between sociodemographic characteristics and other factors with DRD was analyzed using the Fisher t-test, Chi-square test, and Pearson's correlation coefficient test. The association between Hemoglobin A1c (HbA1c) and DRD was analyzed using multiple linear regression analysis. The participants had a mean age of 60.95 ± 7.96, and most were female (68.1%). Of the participants with DRD, 8.9% had moderate to high levels of distress. Education level and family support were significantly associated with the overall level of DRD. Additionally, HbA1c and co-morbidity were also significantly associated with DRD, as were emotional burden and regimen distress. Multiple linear regression analysis found that increased HbA1c was positively associated with increased DRD after adjusting for age, sex, education, duration of T2DM, co-morbidity, diabetic complications, and family support. Screening with DRD may be beneficial in T2DM patients.
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14
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Zheng Y, Weinger K, Greenberg J, Burke LE, Sereika SM, Patience N, Gregas MC, Li Z, Qi C, Yamasaki J, Munshi MN. Actual Use of Multiple Health Monitors Among Older Adults With Diabetes: Pilot Study. JMIR Aging 2020; 3:e15995. [PMID: 32202506 PMCID: PMC7138595 DOI: 10.2196/15995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 12/27/2019] [Indexed: 12/16/2022] Open
Abstract
Background Previous studies have reported older adults’ perceptions of using health monitors; however, no studies have examined the actual use of multiple health monitors for lifestyle changes over time among older adults with type 2 diabetes (T2D). Objective The primary aim of this study was to examine the actual use of multiple health monitors for lifestyle changes over 3 months among older adults with T2D. The secondary aim was to explore changes in caloric intake and physical activity (PA) over 3 months. Methods This was a single-group study lasting 3 months. The study sample included participants who were aged ≥65 years with a diagnosis of T2D. Participants were recruited through fliers posted at the Joslin Diabetes Center in Boston. Participants attended five 60-min, biweekly group sessions, which focused on self-monitoring, goal setting, self-regulation to achieve healthy eating and PA habits, and the development of problem-solving skills. Participants were provided with the Lose It! app to record daily food intake and devices such as a Fitbit Alta for monitoring PA, a Bluetooth-enabled blood glucose meter, and a Bluetooth-enabled digital scale. Descriptive statistics were used for analysis. Results Of the enrolled participants (N=9), the sample was white (8/9, 89%) and female (4/9, 44%), with a mean age of 76.4 years (SD 6.0; range 69-89 years), 15.7 years (SD 2.0) of education, 33.3 kg/m2 (SD 3.1) BMI, and 7.4% (SD 0.8) hemoglobin A1c. Over the 84 days of self-monitoring, the mean percentage of days using the Lose It!, Fitbit Alta, blood glucose meter, and scale were 82.7 (SD 17.6), 85.2 (SD 19.7), 65.3 (SD 30.1), and 53.0 (SD 34.5), respectively. From baseline to completion of the study, the mean daily calorie intake was 1459 (SD 661) at week 1, 1245 (SD 554) at week 11, and 1333 (SD 546) at week 12, whereas the mean daily step counts were 5618 (SD 3654) at week 1, 5792 (SD 3814) at week 11, and 4552 (SD 3616) at week 12. The mean percentage of weight loss from baseline was 4.92% (SD 0.25). The dose of oral hypoglycemic agents or insulin was reduced in 55.6% (5/9) of the participants. Conclusions The results from the pilot study are encouraging and suggest the need for a larger study to confirm the outcomes. In addition, a study design that includes a control group with educational sessions but without the integration of technology would offer additional insight to understand the value of mobile health in behavior changes and the health outcomes observed during this pilot study.
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Affiliation(s)
- Yaguang Zheng
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | | | | | - Lora E Burke
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Matt C Gregas
- Research Services, Boston College, Chestnut Hill, MA, United States
| | - Zhuoxin Li
- Carroll School of Management, Boston College, Chestnut Hill, MA, United States
| | - Chenfang Qi
- North Shore Medical Center, Salem Hospital, Salem, MA, United States
| | - Joy Yamasaki
- Hollywood Presbyterian Medical Center, Los Angeles, CA, United States
| | - Medha N Munshi
- Joslin Diabetes Center, Boston, MA, United States.,Beth Israel Deaconess Medical Center, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
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15
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Castellano-Guerrero AM, Guerrero R, Relimpio F, Losada F, Mangas MA, Pumar A, Martínez-Brocca MA. Prevalence and predictors of depression and anxiety in adult patients with type 1 diabetes in tertiary care setting. Acta Diabetol 2018; 55:943-953. [PMID: 29948408 DOI: 10.1007/s00592-018-1172-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 05/30/2018] [Indexed: 12/12/2022]
Abstract
AIMS To determine gender and age differences in the prevalence of depression and anxiety and their predictive factors in adult patients with type 1 diabetes (DM1). METHODS Random sample of DM1 adult patients from a tertiary care hospital cohort. To evaluate the presence of depression and anxiety, psychological evaluation was performed using structured clinical interview (MINI). For the specific evaluation of fear of hypoglycemia (FH), FH-15 questionnaire was used. RESULTS 339 patients [51.6% male; 38.5 ± 12.9 years; HbA1c 7.5 ± 1.1% (58.5 ± 14.2 mmol/mol); 20.1 ± 12.0 years of DM1] met the inclusion criteria. Prevalence of depression, anxiety, and FH in men vs. women was as follows (%): depression: 15.4 vs. 33.5 (p < 0.05); anxiety: 13.7 vs. 26.2 (p < 0.05); and FH: 42.8 vs. 46.0 (p = NS). Among midlife female patients, prevalence of depression and anxiety was higher compared to male. Moreover, comorbid depressive and anxious symptoms were also higher in midlife female patients compared to age-matched male patients (3.5 vs. 14%, p < 0.05). Apart from age-related vulnerability, female gender, poor glycemic control, and microvascular and macrovascular complications were predictive factors for depressive and anxious symptomatology. Unawareness hypoglycemia and anxiety-prone personality were predictor factors for FH. CONCLUSIONS In adults with DM1, prevalence of depression and anxiety is higher in women. Midlife patients, in particular women, show a significantly higher prevalence of anxiety symptoms and comorbid depression and anxiety. The presence of secondary complications and sustained poor glycemic control should alert to the possibility of these mental disorders, especially in the most vulnerable age population; clinical, gender and age-related patterns could help to design more effective psychological assessment and support in adult patients with DM1.
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Affiliation(s)
- A M Castellano-Guerrero
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - R Guerrero
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - F Relimpio
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - F Losada
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - M A Mangas
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - A Pumar
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Seville, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain
| | - M A Martínez-Brocca
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, Seville, Spain.
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Seville, Spain.
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16
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Indelicato L, Dauriz M, Bacchi E, Donà S, Santi L, Negri C, Cacciatori V, Bonora E, Nouwen A, Moghetti P. Sex differences in the association of psychological status with measures of physical activity and sedentary behaviour in adults with type 2 diabetes. Acta Diabetol 2018; 55:627-635. [PMID: 29582161 DOI: 10.1007/s00592-018-1132-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/15/2018] [Indexed: 10/17/2022]
Abstract
AIM To assess the association of psychological variables on leisure-time physical activity and sedentary time in men and women with type 2 diabetes mellitus (T2D). METHODS In this cross-sectional study, we evaluated 163 patients with T2D, consecutively recruited at the Diabetes Centre of the Verona General Hospital. Scores on depression and anxiety symptoms, psychosocial factors (including self-efficacy, perceived interference, perceived severity, social support, misguided support behaviour, spouse's positive behaviour), physical activity and time spent sitting were ascertained using questionnaires responses to the Beck Depression Inventory-II, Beck Anxiety Inventory, Multidimensional Diabetes Questionnaire, International Physical Activity Questionnaire. RESULTS Physical activity was significantly associated with higher social support in women and with increased self-efficacy in men. Sedentary time was significantly associated with higher perceived interference, anxiety and depressive symptoms, and with reduced diabetes self-efficacy in women, while it was associated solely with anxiety in men. Depressive symptoms and self-efficacy in women and anxiety symptoms in men were independent predictors of sedentary time when entered in a multivariable regression model also including age, BMI, haemoglobin A1c, diabetes duration, perceived interference and self-efficacy as covariates. CONCLUSIONS Lower self-efficacy and higher symptoms of depression were closely associated with increased sedentary time in women, but not in men, with T2D. It is possible that individualized behavioural interventions designed to reduce depressive symptoms and to improve diabetes self-efficacy would ultimately reduce sedentary behaviours, particularly in women with T2D.
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Affiliation(s)
- Liliana Indelicato
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
| | - Marco Dauriz
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy.
| | - Elisabetta Bacchi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Silvia Donà
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Lorenza Santi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Carlo Negri
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Vittorio Cacciatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Enzo Bonora
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
| | - Arie Nouwen
- Department of Psychology, Middlesex University, London, UK
| | - Paolo Moghetti
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Hospital Trust of Verona, Piazzale Stefani, 1, 37126, Verona, Italy
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17
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Aljuaid MO, Almutairi AM, Assiri MA, Almalki DM, Alswat K. Diabetes-Related Distress Assessment among Type 2 Diabetes Patients. J Diabetes Res 2018; 2018:7328128. [PMID: 29770340 PMCID: PMC5892264 DOI: 10.1155/2018/7328128] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 01/20/2018] [Accepted: 02/04/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Diabetes is one of the most common chronic diseases; it is a debilitating and hard to live with. Diabetes-related distress (DRD) refers to the emotional and behavioral changes caused by diabetes. Our study aims to assess the prevalence of DRD among type 2 diabetes (T2D) patients using Diabetes Distress Scale-17 items (DDS-17) and its relation to complications and treatment modalities. METHODS A cross-sectional study of adult T2D patients with follow-up visits at the Diabetes and Endocrinology Center in Taif, Saudi Arabia, between January and July 2017. We excluded patients with other forms of diabetes, untreated hypothyroidism, and psychiatric illness. The total score of DDS-17 was calculated by summing the 17 items' results and then dividing the total by 17. If the total score was >2, then it was considered as clinically significant results (moderate distress), but if it is ≥3, then it is classified as a high distress. RESULTS A total of 509 T2D patients with a mean age of 58 ± 14 years were included. The majority of participants were male, married, not college educated, and reported a sedentary lifestyle. We found 25% of the screened T2D patients have moderate to high DRD. Regarding the DRD components, emotional distress was the most prevalent followed by physician-related distress. HabA1c was significantly higher in those with high combined distress and high emotional distress compared to those with mild/moderate distress (p = 0.015 and 0.030, resp.). CONCLUSION Our study shows that DRD is a medically relevant issue that clinicians need to address. Despite observing a low prevalence of DRD compared to other studies, we found significant correlations between DRD scores and HabA1c, triglyceride levels, BMI, T2D duration, and interval between visits.
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Affiliation(s)
| | | | | | | | - Khaled Alswat
- Taif University School of Medicine, Taif, Saudi Arabia
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