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Zhang M, Zhang X, Yang Y, Weng Y, Chen X, Chen Y, Shi Y. Diabetes Distress Among Patients Undergoing Surgery for Diabetic Retinopathy and Associated Factors: A Cross-Sectional Survey. Psychol Res Behav Manag 2024; 17:1451-1461. [PMID: 38590759 PMCID: PMC10999732 DOI: 10.2147/prbm.s455535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/14/2024] [Indexed: 04/10/2024] Open
Abstract
Background Diabetes distress (DD) is a negative emotion related to diabetes management and a predictor of depression; it affects diabetic retinopathy (DR) patients' quality of life and disease outcomes. The prevalence of DD was higher in patients undergoing surgery for DR. However, few studies have been conducted on DD in DR surgery patients. The present study aims to investigate the status of DD in DR surgery patients and identify factors associated with DD. Methods Using a convenience sampling method, 210 DR surgery patients who were admitted to 2 tertiary-level hospitals in Wenzhou City (Zhejiang Province) and Zhengzhou City (Henan Province) from February to June 2023 were selected as research subjects. A questionnaire collecting demographic and disease-related information, the Diabetes Distress Scale, the Summary of Diabetes Self-Management Activities, the Family Care Index Scale, and the Social Support Rating Scale were used to collect data. Statistical analyses included descriptive statistics, t tests, ANOVAs, Pearson's correlation analyses and stepwise multiple linear regression. This study is reported according to the STROBE guidelines. Results In total, 156 out of 210 (74.29%) DR surgery patients experienced DD, with an average score of 2.13±0.63. The results of the stepwise multiple regression analysis showed that residential location, employment status, self-management level, family support, and social support were significantly associated with DD. These variables accounted for 30.6% of the total variation in DD. Conclusions DR surgery patients exhibit moderate levels of distress. Health care professionals should pay attention to DD in DR surgery patients and develop targeted interventions to improve the self-management ability of these patients, increase their family support and social support to reduce their DD levels.
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Affiliation(s)
- Mengyue Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xiaoxian Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yingrui Yang
- Department of Nursing, Henan Provincial People’s Hospital, Zhengzhou, People’s Republic of China
| | - Yu Weng
- Department of Nursing, The Eye Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xiaojun Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yanyan Chen
- Department of Nursing, The Eye Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Yinghui Shi
- Department of Nursing, The Eye Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
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Tschirhart H, Landeen J, Yost J, Nerenberg KA, Sherifali D. The Examination and Exploration of Diabetes Distress in Pre-existing Diabetes in Pregnancy: A Mixed-methods Study. Can J Diabetes 2024:S1499-2671(24)00056-X. [PMID: 38492737 DOI: 10.1016/j.jcjd.2024.03.001] [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: 09/07/2023] [Revised: 01/15/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVES Diabetes distress (DD) has been understudied in the pregnancy population. Pregnancy is known to be a complex, highly stressful time for women with diabetes because of medical risks and the high burden of diabetes management. Our aim in this study was to explain and understand DD in women with pre-existing diabetes in pregnancy. METHODS An explanatory, sequential mixed-methods study was undertaken. The first strand consisted of a cross-sectional study of 76 women with type 1 and type 2 diabetes. A nested sampling approach was used to re-recruit 18 women back into the second strand for qualitative interviews using an interpretive description approach. RESULTS DD was measured by the validated Problem Area in Diabetes (PAID) scale. A PAID score of ≥40 was positive for distress. DD prevalence was 22.4% in the cross-sectional cohort and the average PAID score was 27.75 (standard deviation 16.08). In the qualitative strand, women with a range of PAID scores (10.0 to 60.0) were sampled for interviews. The majority of these participants described themes of DD in their interviews. Of the 15 women who described DD thematically, only 6 had positive PAID scores. CONCLUSIONS Integration of the mixed-methods data underscores important meta-inferences about DD in pregnancy, namely that DD was present to a greater degree than the PAID tool is sensitive to. DD was present qualitatively in most of the qualitative sample, despite interviewing women with a range of PAID scores. Future research on a pregnancy-specific DD scale is needed.
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Affiliation(s)
- Holly Tschirhart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| | - Janet Landeen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, United States
| | - Kara A Nerenberg
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics & Gynecology, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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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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Ruangchaisiwawet A, Bankhum N, Tanasombatkul K, Phinyo P, Yingchankul N. Prevalence and the association between clinical factors and Diabetes-Related Distress (DRD) with poor glycemic control in patients with type 2 diabetes: A Northern Thai cross-sectional study. PLoS One 2023; 18:e0294810. [PMID: 38011152 PMCID: PMC10681199 DOI: 10.1371/journal.pone.0294810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Glycemic control is important to prevent diabetic complications. However, evidence linking factors such as diabetes-related distress (DRD) to poor glycemic outcomes is lacking in Thailand. Therefore, this study aimed to investigate the prevalence and associated factors of poor glycemic control type 2 diabetes. METHODS A cross-sectional study was conducted on 127 type 2 diabetic patients between December 2021 and March 2022 at Maharaj Nakorn Chiang Mai Hospital, Thailand. Data collection included demographic data, clinical data (duration of being type 2 diabetes, diabetic treatment modalities, weight, height, blood pressure, FBS, and HbA1c), behavioral data (self-care behavior, physical activity, dietary assessment, smoking, alcohol consumption, and sleep quality), and psycho-social data (depression and DRD). Poor glycemic control was defined as not achieving the target HbA1c based on the 2021 American Diabetes Association (ADA) Guideline. Multivariable logistic regression was used to explore the associations between potential factors including DRD, and poor glycemic control. RESULTS The prevalence of poor glycemic control in patients with type 2 diabetes was 29.1%. Our analysis revealed that age under 65 years old (OR 6.40, 95% CI 2.07-19.77, p = 0.001), obesity (BMI ≥ 25 kg/m2) (OR 2.96, 95% CI 1.05-8.39, p = 0.041), and DRD (OR 14.20, 95% CI 3.76-53.64, p<0.001) were significantly associated with poor glycemic control. Three dimensions of DRD were associated with poor glycemic control, including emotional distress (OR 4.23, 95% CI 1.51-11.85, p = 0.006), regimen-related distress (OR 6.00, 95% CI 1.88-19.18, p = 0.003), and interpersonal distress (OR 5.25, 95% CI 1.39-20.02, p = 0.015). CONCLUSION AND RECOMMENDATION Age, obesity, and DRD are associated with poor glycemic control. A holistic approach that includes addressing DRD is crucial for improving glycemic outcomes in patients with type 2 diabetes. Further studies in broader populations using a cohort design are recommended.
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Affiliation(s)
| | - Narumit Bankhum
- Nutrition and Dietary service section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Krittai Tanasombatkul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Nalinee Yingchankul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Seddigh S, Tang TS. Social support and diabetes distress: Does the messenger matter as much as the message? Chronic Illn 2023; 19:681-685. [PMID: 35619542 DOI: 10.1177/17423953221102622] [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] [Indexed: 11/17/2022]
Abstract
We explored the relationship between social support (family/friends and health care team) and four diabetes distress subscales in 196 adults with type 2 diabetes in a specialty care setting. Health care support was associated with lower physician- and regimen-related distress, while friends/family support was related to lower interpersonal distress. The study was registered on clinicaltrials.gov (NCT02804620).
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Affiliation(s)
- Sorayya Seddigh
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tricia S Tang
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Mohsin F, Wyatt L, Belli H, Ali S, Onakomaiya D, Misra S, Yusuf Y, Mammen S, Zanowiak J, Hussain S, Zafar H, Lim S, Islam N, Ahmed N. The Prevalence and Correlates of Diabetes Distress among South Asians Living in New York City (NYC): Baseline Results from a Randomized Trial. RESEARCH SQUARE 2023:rs.3.rs-2806895. [PMID: 37333263 PMCID: PMC10275056 DOI: 10.21203/rs.3.rs-2806895/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Type 2 diabetes (T2D) disproportionately affects South Asians in the United States (US). Living with T2D can be challenging due to the distress it can create for an individual. Distress associated with diabetes, commonly known as diabetes distress (DD), may lead to complications and challenges with the management of diabetes. This study aims to describe the prevalence of DD among a sample of South Asians in New York City (NYC) seeking care in community-based primary care settings and its association with sociodemographic characteristics and clinical measures. Methods This study utilized baseline data from the Diabetes Research, Education, and Action for Minorities (DREAM) Initiative, an intervention designed to reduce hemoglobin A1C (HbA1c) among South Asians with uncontrolled T2D in NYC. DD was measured using the Diabetes Distress Scale (DDS). First, descriptive statistics were used to analyze sociodemographic variables. Chi-square tests assessed categorical variables and Wilcoxon Rank Sum tests assessed continuous variables using a Type I error rate of 0.05. Logistic regression was performed to determine if HbA1c and mental health, along with other covariates, were associated with dichotomized DDS subscales. Results Overall, 415 participants completed the DDS at baseline. Median age was 56 years (IQR: 48-62). A total of 25.9% had high emotional burden distress, 6.6% had high physician-related distress, and 22.2% had high regimen-related distress based on subscales. In adjusted analyses, individuals with any days of poor mental health had significantly higher odds of overall distress (OR:3.7, p=0.014), emotional burden distress (OR:4.9, p<0.001), and physician-related distress (OR:5.0, p=0.002) compared to individuals with no days of poor mental health. Individuals with higher HbA1c had significantly higher odds of regimen-related distress (OR:1.31, p=0.007). Conclusions Findings suggest that DD is prevalent among this sample of South Asians with diagnosed T2D in NYC. Screening for DD in patients with prediabetes/diabetes should be considered by providers to help provide mental and physical health services during primary care visits. Future research can also benefit from a longitudinal analysis of the impact of DD on diabetes self-management, medication adherence, and mental and physical health. Trial registration This study uses baseline data from "Diabetes Management Intervention For South Asians" (NCT03333044), which was registered with clinicaltrials.gov on 6/11/2017.
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Aljohani AA, Almoghamsi EY, Alzaman N, Alharbi MB, Bin Faidh AJ. Diabetes Distress Among Adults With Type 1 Diabetes Mellitus in Saudi Arabia. Cureus 2023; 15:e37525. [PMID: 37193469 PMCID: PMC10182781 DOI: 10.7759/cureus.37525] [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] [Accepted: 04/13/2023] [Indexed: 05/18/2023] Open
Abstract
Background Psychological morbidity is clinically important for diabetes patients because it is often associated with worse glycemic outcomes. This study aimed to assess the prevalence of diabetes distress among adult type 1 diabetes mellitus (DM) patients in the Kingdom of Saudi Arabia (KSA). Methodology A descriptive, cross-sectional study was conducted among type 1 DM patients in KSA from 2021 to 2022. An online validated questionnaire was adopted to collect data, including demographic information, medical and social information, and Saudi Arabian Diabetes Distress Scale-17 (SADDS-17) score to assess diabetes distress. Results This study included 356 type 1 DM patients. Most patients were females (74%), with ages ranging between 14 and 62 years. More than half (53%) had a high level of diabetes distress with a mean score of 3.1 ± 1.23. Among those patients, the highest score (up to 60%) was related to regimen-related distress, the lowest score (around 42%) was related to diabetes-related interpersonal distress, and physician-related distress and emotional burden were reported among 55% and 51%, respectively. More than half (56%) of the patients treated with an insulin pen compared to 43% treated with an insulin pump had high diabetes distress (p = 0.049). The level of HbA1c was significantly higher among patients with high diabetic distress (7.93 ± 1.72 vs. 7.55 ± 1.65; p = 0.038). Conclusions Diabetes distress is prevalent among adult type 1 DM patients in KSA. Therefore, we recommend organizing a screening program for early discovery and prompt psychiatric management, incorporating diabetes education and nutrition consultation to improve their quality of life, and engaging patients in their own management to improve their glycemic control.
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Affiliation(s)
- Alaa A Aljohani
- Department of Family Medicine, Ministry of Health Holdings, Madinah, SAU
| | | | - Naweed Alzaman
- Department of Internal Medicine, College of Medicine Taibah University, Madinah, SAU
| | - Mansour B Alharbi
- Department of Family Medicine, Ministry of Health Holdings, Madinah, SAU
| | - Amjad J Bin Faidh
- Department of Psychiatry, Prince Mohammad Bin Abdulaziz Hospital, Madinah, SAU
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Mach C, Bulanadi J, Gucciardi E, Segal P, De Melo M. Exploring the Needs of Adults Living With Type 1 or Type 2 Diabetes Distress Using the Problem Areas in Diabetes 5 Tool. Can J Diabetes 2023; 47:51-57.e1. [PMID: 36154985 DOI: 10.1016/j.jcjd.2022.07.008] [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: 03/01/2022] [Revised: 07/12/2022] [Accepted: 07/28/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES This study investigated the feasibility and acceptability of implementing a screening tool as a part of routine care and the subsequent screening experiences of patients and clinicians. Additionally, potential sources of diabetes distress (DD) were identified in this clinical population. METHODS Our investigation was a cross-sectional, mixed-methods, convenience sample of 203 patients living with type 1 or type 2 diabetes from 2 Canadian tertiary hospital-based clinics. The Problem Areas in Diabetes 5 (PAID5) scale was used to assess DD. Structured telephone interviews of patients with high DD scores and care provider focus group transcriptions were analyzed using a deductive thematic content analysis. RESULTS The prevalence of DD was 45%. Lack of medication coverage (p=0.02) and presence of neuropathy (p=0.04) were approximately 5- and 2-fold more likely to be predictors of high DD, respectively. Patient interviews identified DD screening as an opportunity to share and feel supported but demonstrated their fear of discussing mental health concerns. Patients found discussion about mental health helpful and often did not require a referral to a mental health specialist. Staff focus groups discussed screening as a feasible tool, but also acknowledged barriers and knowledge gaps that preclude DD screening integration in routine clinical practice. Specialized training for clinicians may help increase confidence and improve uptake of DD screening into routine clinical practice. CONCLUSIONS The prevalence of DD in outpatient care settings is high. Findings suggest that integrating the PAID5 screening tool into regular clinical practice is feasible by patients and care providers.
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Affiliation(s)
- Calvin Mach
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jeroselle Bulanadi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Enza Gucciardi
- School of Nutrition, Ryerson University, Toronto, Ontario, Canada
| | - Phillip Segal
- Faculty of Medicine, Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada; Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Margaret De Melo
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
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Non-Specialized Nurses Roles in Diabetes Inpatient Care in Cyprus: An Interpretive Phenomenological Analysis. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11100464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: The aim of the study was to understand how non-specialized nurses and people with diabetes understand nurses’ roles in diabetes inpatient care. Background: Diabetes mellitus is a major public health issue that places a significant burden on patients and healthcare systems and world leaders have targeted it for priority action. Design: An interpretative phenomenology approach (IPA). Methods: A total of 24 non-specialized nurses working in medical, surgical and nephrology wards and 24 people with type 1 diabetes who use the services of the state hospitals in Cyprus. The data were collected in two phases: firstly, focus groups with nurses (n = 1) and people with diabetes (n = 2) were conducted and analysed and then individual semi-structured interviews with nurses (n = 18) and with people with diabetes (n = 12) were conducted. Findings: It is evident from the study findings that nurses experience several roles in diabetes inpatient care. Most of these roles have been identified by people with diabetes as well. These roles are summarized as follows: medication administration, patient education, screening of complications, diet and psychological support. However, most of the participants raised concerns about nurses’ ability to conduct such roles. Conclusion: Participants suggest that nurses experience several roles in caring for diabetes inpatients and this view was also shared by people with diabetes. However, it was obvious that these roles differ between specialities. The findings showed that even though participants recognized a number of roles in diabetes inpatient care, their description of how they perform these roles was vague, and they raised concerns about their readiness to take on some of these roles.
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Sridhar GR. Can the management of depression in type 2 diabetes be democratized? World J Diabetes 2022; 13:203-212. [PMID: 35432759 PMCID: PMC8984566 DOI: 10.4239/wjd.v13.i3.203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/07/2022] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
Both type 2 diabetes and depression are common and are projected to increase. There is increasing evidence for a bidirectional relationship between the two. Diabetes is a risk factor for depression; contrariwise, individuals with depression are at greater risk of developing diabetes. They are a burden for both the individual and the society. Co-existent depression worsens diabetic control because of obesity, insulin resistance and the adverse metabolic effects of anti-diabetes medicines. In addition, compliance to lifestyle measures required for diabetes is also compromised such as following a specific diet, taking proper medications on time, getting metabolic parameters assessed and maintaining a sleep cycle. Depression occurs in many grades; mild depression is more common in diabetes than frank or full-blown depression leading to suicide. Unfortunately, there are not enough trained and accessible mental health professionals such as psychologists or psychiatrists to deal with the increasing burden of depression in diabetes. Therefore, alternate models for management of mild to moderate depression are required. There is evidence that a team-approach by employing health care assistants can lower the risk of cardiac risk factors. INtegrating DEPrEssioN and Diabetes treatmENT study was carried out to determine whether the team-approach using non-health care professionals could be effective in managing mild to moderate depression and to study its effects on metabolic parameters among subjects with type 2 diabetes mellitus. The international study, carried out in four independent centers in India assessed the impact of a trained but not qualified non-psychiatrist in coordinating and forming a fulcrum between the patient, the family and the consultant endocrinologist/diabetologist. The interventions were fine-tuned to be culturally appropriate by qualitative interviews before they began. It was shown that the outcomes of both depression and diabetes could be improved by the employment of a clinical care coordinator. It is possible to scale up the studies to wider geographical areas and health-care organizations.
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Affiliation(s)
- Gumpeny R Sridhar
- Department of Endocrinology, Endocrine & Diabet Ctr, Visakhapatnam 530002, India
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Kamrul-Hasan ABM, Hannan MA, Asaduzzaman M, Rahman MM, Alam MS, Amin MN, Kabir MR, Chanda PK, Jannat N, Haque MZ, Banik SR, Hasan MJ, Selim S. Prevalence and predictors of diabetes distress among adults with type 2 diabetes mellitus: a facility-based cross-sectional study of Bangladesh. BMC Endocr Disord 2022; 22:28. [PMID: 35065623 PMCID: PMC8783990 DOI: 10.1186/s12902-022-00938-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 01/10/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Diabetes distress (DD) is common and has considerable impacts on diabetes management. Unfortunately, DD is less discussed and frequently underestimated. This study evaluated the prevalence and predictors of DD in adults with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study was conducted at several specialized endocrinology outpatient clinics in Bangladesh from July 2019 to June 2020; 259 adults with T2DM participated. Participants' DD and depression were measured using the 17-item Diabetes Distress Scale (DDS-17) and 9-item Patient Health Questionnaire (PHQ-9), respectively. DDS-17 scores ≥2 and PHQ-9 scores ≥10 were the cutoffs for DD and significant depression, respectively. RESULTS The mean (±SD) age of the participants was 50.36 (±12.7) years, with the majority (54.8%) being male; their median (IQR) duration of diabetes was 6 (3-11) years. Among the study participants, 52.5% had DD (29.7% moderate and 22.8% high DD). The prevalence of emotional burden, physician-related distress, regimen-related distress, and interpersonal distress was 68.7, 28.6, 66, and 37.7%, respectively. Depression was present in 40.5%; 28.6% of the participants had DD and depression. The total DDS-17 score was positively correlated with the PHQ-9 score (r = 0.325, p < 0.001). Rural residence (OR 1.94), presence of any diabetic complication (OR 3.125), insulin use (OR 2.687), and presence of major depression (OR 4.753) were positive predictors of DD. In contrast, age ≥ 40 years at diabetes diagnosis (OR 0.047) and diabetes duration of > 10 years (OR 0.240) were negative predictors of DD (p < 0.05 in all instances). CONCLUSIONS The prevalence of DD in our setting is notably high; DD and depression frequently overlap. Screening for diabetes distress may be considered, especially in high-risk patients.
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Affiliation(s)
- A B M Kamrul-Hasan
- Department of Endocrinology, Mymensingh Medical College, Mymensingh, 2207, Bangladesh.
| | | | - Md Asaduzzaman
- Department of Endocrinology, Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh
| | | | | | | | | | - Palash Kumar Chanda
- Department of Endocrinology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh
| | - Nadia Jannat
- Department of Endocrinology, Aalok Healthcare & Hospital Ltd., Dhaka, Bangladesh
| | - Md Zahurul Haque
- Department of Chronic Diseases, Government Homeopathic Medical College, Dhaka, Bangladesh
| | - Sanjoy Ranjon Banik
- Department of Endocrinology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh
| | | | - Shahjada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Bhaskara G, Budhiarta AAG, Gotera W, Saraswati MR, Dwipayana IMP, Semadi IMS, Nugraha IBA, Wardani IAK, Suastika K. Factors Associated with Diabetes-Related Distress in Type 2 Diabetes Mellitus Patients. Diabetes Metab Syndr Obes 2022; 15:2077-2085. [PMID: 35873530 PMCID: PMC9296679 DOI: 10.2147/dmso.s363431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Diabetes-related distress is a unique emotional problem that is directly related to the burden and anxieties felt by type 2 diabetes mellitus (T2DM) patients. Diabetes-related distress may lead to pessimism and lower self-efficacy which resulted in a deficiency of self-treatment compliance and can cause further bad glycemic control. Knowing the associated factors of diabetic-related distress and solving them may help T2DM patients improve their glycemic control. METHODS This study is an analytical study with cross-sectional design conducted at Sanglah General Hospital from January to April 2021. The data were taken using the consecutive sampling method; 124 samples were collected according to inclusion and exclusion criteria. The participants filled Diabetes Distress Scale questionnaire (DDS17 Bahasa Indonesia). The data analysis was done using univariate (descriptive), bivariate (chi-square) and multivariate (logistic regression) analysis. RESULTS Seventy-five subjects out of 124 (60.5%) had diabetes-related distress. The associated factors of diabetes-related distress one among others are the insulin usage as diabetic therapy (OR= 8.30, 95% CI 2.24-30.72; p = 0.002), had a hypoglycaemia in last 3 months (OR=44.59, 95% CI 4.36-455.51; p = 0.001), had diabetes-related retinopathy (OR=10.28, CI 95% 1.54-68.70; p=0.016), and lack of family support (OR=44.791, 95% CI 10.02-200.22; p < 0.001). CONCLUSION Our present study revealed that diabetes distress prevalence is predominantly and associated among in type 2 diabetes mellitus. We suggest diabetes-related distress screening and regular health promotion which focus on relationship between diabetes and psychological may be a great potential action to improve public health and patient outcomes.
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Affiliation(s)
- Gilang Bhaskara
- Internal Medicine Education Program, Faculty of Medicine, Udayana University, Bali, Indonesia
| | - Anak Agung Gde Budhiarta
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
| | - Wira Gotera
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
| | - Made Ratna Saraswati
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
| | - I Made Pande Dwipayana
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
| | - I Made Siswadi Semadi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
| | - Ida Bagus Aditya Nugraha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
| | | | - Ketut Suastika
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia
- Correspondence: Ketut Suastika, Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia, Tel +62 81 138 0916, Email
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Barbosa EL, Moreno AB, Van Duinkerken E, Lotufo P, Barreto SM, Giatti L, Nunes MA, Viana MC, Figueiredo R, Chor D, Griep RH. The association between diabetes mellitus and incidence of depressive episodes is different based on sex: insights from ELSA-Brasil. Ther Adv Endocrinol Metab 2022; 13:20420188221093212. [PMID: 35464879 PMCID: PMC9019382 DOI: 10.1177/20420188221093212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 03/23/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To investigate the association between diabetes mellitus (DM) and incidence of depressive episodes among men and women. METHODS Data were used from 12,730 participants (5866 men and 6864 women) at baseline (2008-2010) and follow-up 1 (2012-2014) of the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort of Brazilian civil servants. Participants were classified for diabetes using self-reported and clinical information, and evaluated for presence of depressive episodes by the Clinical Interview Schedule-Revised (CIS-R). Associations were estimated by means of logistic regression models (crude and adjusted for socio-demographic variables). RESULTS Women classified as with DM prior to the baseline were at 48% greater risk (95% confidence interval (CI) = 1.03-2.07) of depressive episodes in the crude model and 54% greater risk (95% CI = 1.06-2.19) in the final adjusted model compared to women classified as non-DM. No significant associations were observed for men. The regression models for duration of DM and incidence of depressive episodes (n = 2143 participants; 1160 men and 983 women) returned no significant associations. CONCLUSION In women classified as with prior DM, the greater risk of depressive episodes suggests that more frequent screening for depression may be beneficial as part of a multi-factorial approach to care for DM.
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Affiliation(s)
- Elizabeth Leite Barbosa
- National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Arlinda B. Moreno
- National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Eelco Van Duinkerken
- Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
- Graffée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands
| | - Paulo Lotufo
- University of São Paulo, Cidade Universitária, São Paulo, Brazil
| | - Sandhi Maria Barreto
- Medical School & Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Luana Giatti
- Medical School & Clinical Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Dóra Chor
- National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Azadbakht M, Fadayevatan R, Tanjani PT, Foroughan M, Zanjari N. Prevalence and Determinant Factors of Diabetes Distress in Community-Dwelling Elderly in Qom, Iran. Int J Prev Med 2021; 12:145. [PMID: 34912521 PMCID: PMC8631124 DOI: 10.4103/ijpvm.ijpvm_372_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/23/2020] [Indexed: 11/05/2022] Open
Abstract
Background: Diabetes distress (DD) is common among the patients with type 2 diabetes (T2D), but few studies investigated this problem and its related factors in the elderly population. This study has focused on the prevalence rate of DD and its determinants in community-dwelling elderly in Qom, Iran. Methods: This study was cross-sectional. A total of 519 subjects community-dwelling with T2D participated in the study. Collected data contained sociodemographic information, some clinical variables (body mass index and duration of diabetes) knowledge, attitude, and self-efficacy. Participants' distress was measured via diabetes distress scale (DDS). The cut of 3 (≥3) was considered as the presence of distress. Also, the attitude, self-efficacy, and knowledge about diabetes were measured by questioner. Multiple logistic regression analysis was applied to detect predictors of DD. Results: The mean age of the participants was 68.38 ± 6.78 and 53.6% were female. Among the participants, 48.6% were identified with positive DD. According to the results of logistic regression analysis, being female (odds ration [OR] = 1.688, P = 0.009), being widowed or divorced (OR = 1.629, P = 0.027), being over-weight or obese (OR = 1.627, P = 0.027), and having less than 10 years in disease duration (OR = 1.721, P = 0.029), attitude (OR = 0.590, P < 0.001), and self-efficacy (OR = 0.658, P = 0.009) were identified as the independent predictors of DD. No significant association was found between DD and age, occupational status, education level, and knowledge (P > 0.05). Conclusions: The prevalence of DD is considerable among the elderly in Qom. It seems that more attention should be paid to the mental aspects of the patients with T2D specially in high risk groups.
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Affiliation(s)
- Mojtaba Azadbakht
- Department of Aging, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Department of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Reza Fadayevatan
- Department of Aging, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Parisa Taheri Tanjani
- Department of Internal Medicine, Ayatollah Taleghani Hospital, Research Development Unit, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Foroughan
- Department of Aging, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nasibeh Zanjari
- Department of Aging, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Arifuddin F, Syam Y, Arafat R, Adiputra AB. Overview of diabetes distress in diabetes patients who do not participate in PROLANIS (Chronic Disease Management Program): A pilot study. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Atitudes para o autocuidado em diabetes mellitus tipo 2 na Atenção Primária. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao001765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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17
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Factors Associated with Diabetes-Related Distress in Patients with Type 2 Diabetes Mellitus. JOURNAL OF INTERDISCIPLINARY MEDICINE 2021. [DOI: 10.2478/jim-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: The aim of this study was to identify factors associated with diabetes-related distress (DRD) in adult patients with type 2 diabetes mellitus (T2DM).
Material and Methods: This was an analysis of data previously obtained from two cross-sectional studies, in which medical charts review and direct interviews were employed to obtain medical and demographic data. Vital status assessment and anthropometric measurements were performed. The patients filled out specific questionnaires for DRD (DDS-17), symptoms of depression (PHQ-9), and of anxiety (GAD-7). A clinical meaningful threshold for DRD was set at ≥2.0 points. Symptoms of depression and anxiety, number of chronic complications, therapy for T2DM, anthropometric and cardio-metabolic parameters, as well as demographic, socio-economic data, and lifestyle habits were evaluated as factors possibly associated with DRD by univariate and multiple regression analyses.
Results: A total of 271 patients with T2DM were included in this analysis, of whom 25.1% presented a DDS-17 score ≥2 points (and 9.96% a DDS-17 score ≥3). Subjects with a DDS-17 score ≥2 had higher HbA1c levels (p = 0.018), PHQ-9 and GAD-7 scores (p <0.0001 for both). The multiple regression model indicated that anxiety (p = 0.026), depression (p = 0.001), and ethnicity (p = 0.002) were significantly correlated with DRD (p <0.0001). With regards to subscales, the HbA1c (p = 0.005) and PHQ-9 score (p <0.0001) were significantly associated with emotional burden, ethnicity (p = 0.001) and depression (p = 0.004) with regimen-related distress, whereas ethnicity (p = 0.010) and GAD-7 score (p = 0.012) with interpersonal distress.
Conclusions: Psychosocial factors like depression, anxiety, or ethnicity significantly contribute to DRD in patients with T2DM, and worse glycemic control is associated with emotional burden.
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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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Noman SM, Arshad J, Zeeshan M, Rehman AU, Haider A, Khurram S, Cheikhrouhou O, Hamam H, Shafiq M. An Empirical Study on Diabetes Depression over Distress Evaluation Using Diagnosis Statistical Manual and Chi-Square Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073755. [PMID: 33916851 PMCID: PMC8038424 DOI: 10.3390/ijerph18073755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 02/05/2023]
Abstract
Diabetes distress is an alternative disorder that is often associated with depression syndromes. Psychosocial distress is an alternative disorder that acts as a resistance to diabetes self-care management and compromises diabetes control. Yet, in Nigeria, the focus of healthcare centers is largely inclined toward the medical aspect of diabetes that neglects psychosocial care. In this retrospective study, specific distress was measured by the Diabetes Distress Screening (DDS) scale, and depression was analyzed by the Beck Depression Inventory (BDI) and Diagnosis Statistics Manual (DSM) criteria in type 2 diabetes mellitus (T2DM) patients of Northwestern Nigeria. Additionally, we applied the Chi-square test and linear regression to measure the forecast prevalence ratio and evaluate the link between the respective factors that further determine the odd ratios and coefficient correlations in five nonintrusive variables, namely age, gender, physical exercise, diabetes history, and smoking. In total, 712 sample patients were taken, with 51.68% male and 47.31% female patients. The mean age and body mass index (BMI) was 48.6 years ± 12.8 and 45.6 years ± 8.3. Based on the BDI prediction, 90.15% of patients were found depressed according to the DSM parameters, and depression prevalence was recorded around 22.06%. Overall, 88.20% of patients had DDS-dependent diabetes-specific distress with a prevalence ratio of 24.08%, of whom 45.86% were moderate and 54.14% serious. In sharp contrast, emotion-related distress of 28.96% was found compared to interpersonal (23.61%), followed by physician (16.42%) and regimen (13.21%) distress. The BDI-based matching of depression signs was also statistically significant with p < 0.001 in severe distress patients. However, 10.11% of patients were considered not to be depressed by DSM guidelines. The statistical evidence indicates that depression and distress are closely correlated with age, sex, diabetes history, physical exercise, and smoking influences. The facts and findings in this work show that emotional distress was found more prevalent. This study is significant because it considered several sociocultural and religious differences between Nigeria and large, undeveloped, populated countries with low socioeconomic status and excessive epidemiological risk. Finally, it is important for the clinical implications of T2DM patients on their initial screenings.
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Affiliation(s)
- Sohail M. Noman
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou 515041, China;
| | - Jehangir Arshad
- Department of Electrical & Computer Engineering, COMSATS University Islamabad, Lahore Campus, Lahore 54000, Pakistan;
| | - Muhammad Zeeshan
- Department of Medicine and Surgery, Al-Nafees Medical College and Hospital, Isra University, Islamabad 44000, Pakistan;
| | - Ateeq Ur Rehman
- Department of Electrical Engineering, Government College University, Lahore 54000, Pakistan;
| | - Amir Haider
- Department of Intelligent Mechatronics Engineering, Sejong University, Seoul 05006, Korea;
| | - Shahzada Khurram
- Faculty of Computing, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan;
| | - Omar Cheikhrouhou
- College of CIT, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Habib Hamam
- Faculty of Engineering, Moncton University, Moncton, NB E1A3E9, Canada;
| | - Muhammad Shafiq
- Department of Information and Communication Engineering, Yeungnam University, Gyeongsan 38541, Korea
- Correspondence:
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Huynh G, Tran TT, Do THT, Truong TTD, Ong PT, Nguyen TNH, Pham LA. Diabetes-Related Distress Among People with Type 2 Diabetes in Ho Chi Minh City, Vietnam: Prevalence and Associated Factors. Diabetes Metab Syndr Obes 2021; 14:683-690. [PMID: 33623403 PMCID: PMC7894807 DOI: 10.2147/dmso.s297315] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/29/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Diabetes-related distress (DRD) refers to the condition of negative emotion as a result of living with diabetes and the burden of self-care. This study aims to evaluate the prevalence and associated factors of DRD among people with type 2 diabetes. METHODS A cross-sectional study was carried out on people with Type 2 Diabetes at three hospitals in Ho Chi Minh City, between April and November 2020. The study used the Vietnamese version of the Diabetes Distress Scale (DDS) which includes 17 items. The mean total distress score was calculated on the average of the 17 items. A mean score of equal to 2.0 or higher was classified as moderate to severe distress. Descriptive statistics were performed by frequency and percentage, and the multivariate Logistic Regression Analysis was used to assess information where p-value <0.05 was considered statistically significant. RESULTS A total of 517 participants, who were mainly over 60 years old (56.8%) with females being 65.0%, participated in the study. Results showed that 23.6% and 5.8% of them, respectively, were found as being moderately or highly distressed. Some factors that correlated with the total distress results included age, timescale of diabetes, and glycemic control level (HbA1c). The rate of total distress in those who were over 60 years old and had a HbA1c <7 were less prevalent than those who were under 60, and had a HbA1c ≥7 (OR 0.5 95% CI 0.3-0.7; OR 0.5 95% CI: 0.3-0.9, respectively, all p<0.05), whilst the timescale of diabetes between 5 and 10 years was significantly more prevalent than those who had a timescale less 5 years (OR 1.8 95% CI 1.1-2.9, p<0.05). CONCLUSION A high rate of distress exists in people with diabetes. Therefore, combining the evaluation of distress as part of the regular diagnostic procedures of diabetes care, and recommending physicians apply a comprehensive approach to diabetes management, is necessary.
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Affiliation(s)
- Giao Huynh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thien Thuan Tran
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thi Hoai Thuong Do
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thi Thuy Dung Truong
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Phuc Thinh Ong
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Thi Ngoc Han Nguyen
- Infection Control Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le An Pham
- Family Medicine Training Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Correspondence: Le An Pham; Giao Huynh University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, VietnamTel +84908153743; +84908608338 Email ;
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Bawa H, Poole L, Cooke D, Panagi L, Steptoe A, Hackett RA. Diabetes-related distress and daily cortisol output in people with Type 2 diabetes. Diabetes Res Clin Pract 2020; 169:108472. [PMID: 33002546 DOI: 10.1016/j.diabres.2020.108472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/03/2020] [Accepted: 09/21/2020] [Indexed: 01/17/2023]
Abstract
AIMS Diabetes-related distress is common in Type 2 Diabetes and is linked with poor diabetes control. However, mechanisms underlying this association are unclear. One pathway that could be involved is neuroendocrine dysfunction, as Type 2 Diabetes is associated with altered diurnal cortisol output. This study investigated the link between diabetes-related distress and diurnal cortisol output. METHODS 134 people with Type 2 Diabetes provided 5 cortisol samples over the course of a day. Multivariate linear regression models were used to assess whether overall and sub-domains of diabetes-related distress measured by the Diabetes Distress Scale, predicted cortisol parameters (waking cortisol, cortisol awakening response, cortisol slope and evening cortisol). RESULTS Physician-related distress was associated with greater waking (B = 2.747, p = .015) and evening cortisol (B = 1.375, p = .014), and a blunted cortisol awakening response (B = -3.472, p = .038) adjusting for age, sex, income, body mass index, smoking and time of awakening. No associations were detected for overall distress, emotional, interpersonal or regimen distress. CONCLUSION Physician-related distress was associated with alterations in daily cortisol output. Longitudinal research is required to understand how physician-related distress is associated with diurnal cortisol patterning over time.
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Affiliation(s)
- Hetashi Bawa
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Lydia Poole
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, Surrey, UK.
| | - Laura Panagi
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Ruth A Hackett
- Department of Behavioural Science and Health, University College London, London, UK; Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Yu C, Choi D, Bruno BA, Thorpe KE, Straus SE, Cantarutti P, Chu K, Frydrych P, Hoang-Kim A, Ivers N, Kaplan D, Leung FH, Maxted J, Rezmovitz J, Sale J, Sodhi-Helou S, Stacey D, Telner D. Impact of MyDiabetesPlan, a Web-Based Patient Decision Aid on Decisional Conflict, Diabetes Distress, Quality of Life, and Chronic Illness Care in Patients With Diabetes: Cluster Randomized Controlled Trial. J Med Internet Res 2020; 22:e16984. [PMID: 32996893 PMCID: PMC7557444 DOI: 10.2196/16984] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 05/04/2020] [Accepted: 08/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Person-centered care is critical for delivering high-quality diabetes care. Shared decision making (SDM) is central to person-centered care, and in diabetes care, it can improve decision quality, patient knowledge, and patient risk perception. Delivery of person-centered care can be facilitated with the use of patient decision aids (PtDAs). We developed MyDiabetesPlan, an interactive SDM and goal-setting PtDA designed to help individualize care priorities and support an interprofessional approach to SDM. OBJECTIVE This study aims to assess the impact of MyDiabetesPlan on decisional conflict, diabetes distress, health-related quality of life, and patient assessment of chronic illness care at the individual patient level. METHODS A two-step, parallel, 10-site cluster randomized controlled trial (first step: provider-directed implementation only; second step: both provider- and patient-directed implementation 6 months later) was conducted. Participants were adults 18 years and older with diabetes and 2 other comorbidities at 10 family health teams (FHTs) in Southwestern Ontario. FHTs were randomly assigned to MyDiabetesPlan (n=5) or control (n=5) through a computer-generated algorithm. MyDiabetesPlan was integrated into intervention practices, and clinicians (first step) followed by patients (second step) were trained on its use. Control participants received static generic Diabetes Canada resources. Patients were not blinded. Participants completed validated questionnaires at baseline, 6 months, and 12 months. The primary outcome at the individual patient level was decisional conflict; secondary outcomes were diabetes distress, health-related quality of life, chronic illness care, and clinician intention to practice interprofessional SDM. Multilevel hierarchical regression models were used. RESULTS At the end of the study, the intervention group (5 clusters, n=111) had a modest reduction in total decisional conflicts compared with the control group (5 clusters, n=102; -3.5, 95% CI -7.4 to 0.42). Although there was no difference in diabetes distress or health-related quality of life, there was an increase in patient assessment of chronic illness care (0.7, 95% CI 0.4 to 1.0). CONCLUSIONS Use of goal-setting decision aids modestly improved decision quality and chronic illness care but not quality of life. Our findings may be due to a gap between goal setting and attainment, suggesting a role for optimizing patient engagement and behavioral support. The next steps include clarifying the mechanisms by which decision aids impact outcomes and revising MyDiabetesPlan and its delivery. TRIAL REGISTRATION ClinicalTrials.gov NCT02379078; https://clinicaltrials.gov/ct2/show/NCT02379078.
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Affiliation(s)
- Catherine Yu
- St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
| | - Dorothy Choi
- St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
| | - Brigida A Bruno
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kevin E Thorpe
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
| | - Sharon E Straus
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
| | | | - Karen Chu
- Bridgepoint Active Healthcare (Sinai Health System), Toronto, ON, Canada
| | - Paul Frydrych
- Mount Dennis Weston Health Centre, Humber River Family Health Team, Toronto, ON, Canada
| | - Amy Hoang-Kim
- St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
| | - Noah Ivers
- Department of Family and Community Medicine, Women's College Hospital, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - David Kaplan
- University of Toronto, Toronto, ON, Canada
- North York General Hospital, Toronto, ON, Canada
| | - Fok-Han Leung
- St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
| | - John Maxted
- Markham Stouffville Hospital, Markham, ON, Canada
| | | | - Joanna Sale
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital (Unity Health Toronto), Toronto, ON, Canada
| | - Sumeet Sodhi-Helou
- Toronto Western Family Health Team, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Dawn Stacey
- School of Nursing, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Deanna Telner
- South East Toronto Family Health Team (Toronto East Health Network), Toronto, ON, Canada
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Onyenekwe B, Young E, Nwatu C, Okafor C, Ugwueze C. Diabetes Distress and Associated Factors in Patients with Diabetes Mellitus in South East Nigeria. DUBAI DIABETES AND ENDOCRINOLOGY JOURNAL 2020. [DOI: 10.1159/000508706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
<b><i>Background:</i></b> Diabetes distress (DD) is a common worldwide problem in diabetic patients irrespective of age and type of treatment. In the DAWN 2 study (Diabetes Attitudes, Wishes, and Needs), DD was reported by 44.6% of participants. <b><i>Objectives:</i></b> The purpose of this study was to assess the prevalence and level of DD and its associated factors among adult diabetic patients in South East Nigeria. <b><i>Methods:</i></b> The present study was cross-sectional and descriptive. Patients attending the adult diabetes clinic were enrolled. The questionnaire was administered by the investigators. All patients were eligible. Their demographic and clinical data were obtained. They were screened for DD using the DD Scale (DDS)-2 and DDS-17. Data were tabulated and analyzed using SPSS version 21. <b><i>Results:</i></b> There were 110 subjects (38 males and 72 females), aged 36–85 years (60.5 ± 10.0). Only 9 (8.2%) had diabetes mellitus (DM) type 1, while the rest had type 2 DM. Twenty-five subjects (22.7%) were on insulin injection. Hypertension was coexistent in 72%, and they were prescribed 3–10 medications (5.9 ± 1.5) at the time of assessment. The male and female subjects were comparable. Moderate to severe DD was present in 51.9% (DDS-17). The average scores were for DDS-2, 3.1; DDS-17, 2.3; emotional burden, 2.9; physician-related distress, 1.4; regimen-related distress, 2.5, and interpersonal distress, 2.2. Distress was significantly associated with a younger age, T1DM, longer duration of diabetes, use of insulin injection, and HbA<sub>1C</sub> level. <b><i>Conclusion:</i></b> DD is a common consequence of living with diabetes and impairs diabetes self-care behavior and glycemic control. Active screening for DD should be an integral part of diabetes care. Diabetes self-management education and support should be implemented at diagnosis and as needed thereafter, especially when DD is diagnosed.
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Amankwah-Poku M, Amoah AGB, Sefa-Dedeh A, Akpalu J. Psychosocial distress, clinical variables and self-management activities associated with type 2 diabetes: a study in Ghana. Clin Diabetes Endocrinol 2020; 6:14. [PMID: 32685189 PMCID: PMC7362489 DOI: 10.1186/s40842-020-00102-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022] Open
Abstract
Aim Psychosocial distress can act as a barrier to diabetes self-care management and thus compromise diabetes control. Yet in Ghana, healthcare centres mainly focus on the medical aspect of diabetes to the neglect of psychosocial care. This study determined the relationship amongst psychosocial distress, clinical variables, and self-management activities associated with type 2 diabetes management. Method Questionnaires were administered to 162 patients from four hospitals in Accra, Ghana, to assess psychosocial distress (e.g. diabetes distress), clinical variables (e.g. glycaemic control), and self- management activities (e.g. medication intake) related to diabetes. In assessing diabetes distress, the use of the PAID allowed evaluation of broader range of emotional concerns (diabetes-related emotional distress), while the DDS allowed evaluation of factors more closely related to diabetes self-management (diabetes distress). Results Diabetes-related emotional distress, diabetes distress and depressive symptoms were reciprocally positively correlated, while non-supportive family behaviour correlated negatively with these psychological variables. Diabetes-related emotional distress correlated positively with systolic and diastolic blood pressure, and correlated negatively with exercise regimen. On the other hand, diabetes distress correlated negatively with dietary and exercise regimen and correlated positively with glycaemic levels, while depressive symptoms correlated positively with glycaemic levels, diabetes complication and systolic blood pressure. Contrary to the literature, non-supportive family behaviour correlated positively with diet, exercise and medication regimen. Conclusion The positive association of psychological variables with glycaemic levels and blood pressure levels, and the positive association of non-supportive family behaviour with self-management activities suggests the need for psychosocial care to be incorporate in the management of type 2 diabetes in Ghana. Patients can be screened for diabetes-related distress and symptoms of depression and provided psychosocial care where necessary.
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Affiliation(s)
- Margaret Amankwah-Poku
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, P.O. Box L 84, Legon, Accra, Ghana
| | - Albert G B Amoah
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Araba Sefa-Dedeh
- Department of Psychiatry, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Josephine Akpalu
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Kalra G, Gill S, Tang TS. Depression and Diabetes Distress in South Asian Adults Living in Low- and Middle-Income Countries: A Scoping Review. Can J Diabetes 2020; 44:521-529.e1. [PMID: 32792106 DOI: 10.1016/j.jcjd.2020.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES In this study, we conducted a scoping review to identify the prevalence of both depression and diabetes distress in patients with type 2 diabetes in low- and middle-income countries in South Asia. METHODS This scoping review was grounded in the methodology of Arksey and O'Malley by searching for relevant studies using Ovid MEDLINE, PsycINFO and Cumulative Index of Nursing and Allied Health Literature databases, as well as grey literature sources and hand searches. Two reviewers independently screened and extracted data from articles that met the inclusion criteria. RESULTS A total of 46 studies were included, with only 1 addressing both depression and diabetes distress. We present 42 total articles on depression and 5 on diabetes distress. The prevalence of type 2 diabetes and elevated depressive symptoms ranged from 11.6% to 67.5%, whereas the prevalence of diabetes distress ranged from 18.0% to 76.2%. CONCLUSIONS The prevalence of elevated depressive symptoms was found to be much higher than that reported in data from high-income countries and in data on South Asians living in high-income countries. Diabetes distress was found to be lower compared with other studies; however, the scarcity of data makes this observation inconclusive. Variations in depression inventories, lack of culturally tailored inventories and the focus on urban clinic-based populations are identified as limitations and areas requiring further research. Our review provides evidence for the need of increased mental health screening and treatment in diabetes care in South Asian countries.
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Affiliation(s)
- Gunisha Kalra
- Faculty of Health Sciences-Global Health, McMaster University, Hamilton, Ontario, Canada
| | - Simran Gill
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tricia S Tang
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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Alzughbi T, Badedi M, Darraj H, Hummadi A, Jaddoh S, Solan Y, Sabai A. Diabetes-Related Distress and Depression in Saudis with Type 2 Diabetes. Psychol Res Behav Manag 2020; 13:453-458. [PMID: 32547267 PMCID: PMC7239888 DOI: 10.2147/prbm.s255631] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/08/2020] [Indexed: 12/14/2022] Open
Abstract
Objective This study aims to assess the prevalence of diabetes mellitus (DM)-related distress and depression and their associated factors in Saudi people with type 2 DM (T2DM) in Jazan, Saudi Arabia. It also aims to assess the association between glycemic control and DM-related distress and depression. Methods This is an analytical, cross-sectional study which recruited 300 Saudi patients with T2DM randomly from primary healthcare centers in Jazan, Saudi Arabia. DM-related distress and depression were measured by valid questionnaires, the 17-item Diabetes Distress Scale and the Patient Health Questionnaire-9, respectively. Logistic regression and an independent t-test were performed in the statistical analysis. Results The mean age of the study population was 52.7 years, with a range of 23–83 years. The number of males was 147 (49%) and females was 153 (51%) in the study population. The prevalence of DM-related distress and depression in Saudi patients with T2DM in Jazan was 22.3% and 20%, respectively, and about 7.7% had both. Of DM-related distress, 12.3% had interpersonal-related DM distress, 11.7% had physician-related DM distress, 10.7% had emotional-related DM distress, and 7% had regimen-related DM distress. After adjusting for covariates, being female, patients aged <45, physical inactivity, DM duration <5 years, and smoking were significantly associated with DM-related distress and depression. There was also a significant association between DM-related distress and depression, OR = 3 [95% CI: 1.8, 6.4]. Furthermore, we found that glycated hemoglobin (A1C) levels were significantly higher in those with DM-related distress (small effect size, eta squared = 0.04) and depression (moderate effect size, eta squared = 0.06) (P < 0.001). Conclusion DM-related distress and depression are prevalent in patients with T2DM in Jazan, Saudi Arabia. Both these conditions need to be screened for and addressed in clinical settings. Establishing the causality of DM-related distress and depression in T2DM is an important aim for any future studies.
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Affiliation(s)
- Turki Alzughbi
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Mohammed Badedi
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Hussain Darraj
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Abdulrahman Hummadi
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Sattam Jaddoh
- Jazan Psychiatry Hospital, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Yahiya Solan
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Abdullah Sabai
- Public Health Administration, Jazan Health Affairs, Jazan, Saudi Arabia
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Azadbakht M, Taheri Tanjani P, Fadayevatan R, Froughan M, Zanjari N. The prevalence and predictors of diabetes distress in elderly with type 2 diabetes mellitus. Diabetes Res Clin Pract 2020; 163:108133. [PMID: 32272188 DOI: 10.1016/j.diabres.2020.108133] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 01/18/2023]
Abstract
AIMS Diabetes distress (DD) leads to damaging consequences in patients with type 2 diabetes mellitus (T2DM). Few studies have been carried out on the DD among elderly in Iran. The aim of the current study was to investigate the prevalence of DD and some of its related factors on the elderly living in Qom, Iran. METHODS This study was cross-sectional, in design. It lasted for three months (December to February 2018). 519 community dwelling(aged 60 and over) participated in the study. Participants' distress measured by diabetes distress scale (DDS). The cut of 3(≥3) was considered as the presence of distress. In addition, socio-demographic information was assessed. In order to determine predictors factors of DD, the logistic regression analysis was applied. RESULTS The mean age (±SD) of the participants was 68.38 (SD:6.78) with the majority being female (53.6%). Among them, 48.6% were identified with DD. A multi-variable logistic regression analysis showed that being female (OR = 1.94, [ 1.30-2.31]), sedentary lifestyle (OR = 3.59, [1.43-9.03]), complications (OR = 3.10, [2.06-4.67]), body mass index (BMI) of 25 or more (OR = 2.46, [1.54-3.94]), duration of disease below 10 years (OR = 2.60, [ 1.56-4.31]), two comorbidity (OR = 2.07, [ 1.19-3.61]) and three or more comorbidity (OR = 3.51, [ 1.20-10.27]) are the predictors of DD. CONCLUSIONS DD is notably prevalent among the elderly with T2DM. Attention to psychological aspects of diabetes is a health priority, especially among women and other high-risk groups.
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Affiliation(s)
- Mojtaba Azadbakht
- Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Parisa Taheri Tanjani
- Department of Internal Medicine, School of Medicine, Ayatollah Taleghani Hospital, Research Development Unit, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Fadayevatan
- Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mahshid Froughan
- Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nasibeh Zanjari
- Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Liu SY, Huang J, Dong QL, Li B, Zhao X, Xu R, Yin HF. Diabetes distress, happiness, and its associated factors among type 2 diabetes mellitus patients with different therapies. Medicine (Baltimore) 2020; 99:e18831. [PMID: 32176027 PMCID: PMC7440060 DOI: 10.1097/md.0000000000018831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study aimed to investigate diabetes distress, happiness, and its associated factors of patients with type 2 diabetes mellitus (T2DM) treated by different therapies, and to analyze the related impact factors. A total of 1512 patients with T2DM were randomly selected from 18 tertiary hospitals in Hunan province from January 2016 to April 2016 who has been treated with oral antidiabetics monotherapy, insulin monotherapy, and combination therapy. Use the general information questionnaire, WHO-5 (the World Health Organization 5 well-being index) and PAID (the problem areas in diabetes scale) to collect the data. There are 846 (55.95%) patients that have serious emotional disorders, and the diabetes related distress in insulin treatment group was higher than that in combination treatment group (P < .05). Happiness of T2DM patients in combination therapy was higher than oral antidiabetic drug monotherapy and insulin monotherapy (P < .05). There was a negative correlation between diabetic suffering and happiness in patients with different treatments (R ranged from -0.335 to -0.436, P < .001). Age and happiness experience could explain 14.8% of the variance. Acute and chronic complications, controlled blood glucose level, lifestyle, therapies, and school education can explain 18.3% variance. Under different therapies, the suffering and happiness of T2DM patients differed from each other. The suffering and happiness of T2DM were related to different therapies, age, complications, glycaemic control, lifestyle, school education, and so on.
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Affiliation(s)
- Shun-Ying Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University
| | - Jin Huang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University
| | - Qiao-Liang Dong
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University
| | - Bei Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University
| | - Xue Zhao
- the affiliated hospital of Guizhou medical university
| | - Rong Xu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University
| | - Hong-Fang Yin
- Department of Endocrinology, Hunan Provincial People's Hospital, Changsha, Hunan, P.R. China
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Li CI, Liu CS, Lin CH, Lin WY, Lee YD, Yang SY, Li TC, Lin CC. Competing risk analysis on visit-to-visit glucose variations and risk of depression: The Taiwan Diabetes Study. DIABETES & METABOLISM 2019; 46:223-229. [PMID: 31472230 DOI: 10.1016/j.diabet.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/09/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
AIM Patients with diabetes have higher rates of depression than does the general population, but diabetes management mainly aims to maintain glucose stability. For this reason, our study assessed the relationship between 1-year variations in fasting plasma glucose (FPG) and risk of depression in Chinese patients with type 2 diabetes (T2D). METHODS This retrospective cohort study was conducted on 32,829 patients aged ≥30 years who were diagnosed with T2D and who participated in the National Diabetes Case Management Program in Taiwan. Their 1-year FPG variation as a predictor was determined by coefficient of variation (CV), whereas depressive events were analyzed by Cox's proportional hazards models. RESULTS During a mean 8.23 years of follow-up, 1041 new cases of depression were diagnosed. When patients were grouped based on quartiles of FPG-CV, incidence rates were 3.23, 3.49, 3.96 and 4.80 per 1000 person-years in the first, second, third and fourth quartile subgroups, respectively. After adjusting for traditional risk factors, baseline fasting glucose and HbA1c levels, and diabetes complications, FPG-CV was independently linked with incident depression. Hazard ratios of depression for FPG-CV in the fourth vs first quartile subgroups was 1.33 (95% CI: 1.11-1.59), respectively. CONCLUSION Patients whose 1-year FPG variations were>42.6% had an increased risk of depression, thus suggesting that FPG variations may be a predictor of depression in patients with T2D. Also, glucose variation during outpatient visits may be an indicator for individualized diabetes management in clinical practice.
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Affiliation(s)
- C-I Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - C-S Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - C-H Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - W-Y Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Y-D Lee
- Department of Psychiatry, Medical College, National Cheng-Kung University, Tainan, Taiwan
| | - S-Y Yang
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - T-C Li
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - C-C Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
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Bruno BA, Choi D, Thorpe KE, Yu CH. Relationship Among Diabetes Distress, Decisional Conflict, Quality of Life, and Patient Perception of Chronic Illness Care in a Cohort of Patients With Type 2 Diabetes and Other Comorbidities. Diabetes Care 2019; 42:1170-1177. [PMID: 31048410 DOI: 10.2337/dc18-1256] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 03/31/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The primary outcome is to evaluate the relationship between diabetes distress and decisional conflict regarding diabetes care in patients with diabetes and two or more comorbidities. Secondary outcomes include the relationships between diabetes distress and quality of life and patient perception of chronic illness care and decisional conflict. RESEARCH DESIGN AND METHODS This was a cross-sectional study of 192 patients, ≥18 years of age, with type 2 diabetes and two or more comorbidities, recruited from primary care practices in the Greater Toronto Area. Baseline questionnaires were completed using validated scales: Diabetes Distress Scale (DDS), Decisional Conflict Scale (DCS), Short-Form Survey 12 (SF-12), and Patient Assessment of Chronic Illness Care (PACIC). Multiple linear regression models evaluated associations between summary scores and subscores, adjusting for age, education, income, employment, duration of diabetes, and social support. RESULTS Most participants were >65 years old (65%). DCS was significantly and positively associated with DDS (β = 0.0139; CI 0.00374-0.0246; P = 0.00780). DDS-emotional burden subscore was significantly and negatively associated with SF-12-mental subscore (β =-3.34; CI -4.91 to -1.77; P < 0.0001). Lastly, DCS was significantly and negatively associated with PACIC (β = -6.70; CI -9.10 to -4.32; P < 0.0001). CONCLUSIONS We identified a new positive relationship between diabetes distress and decisional conflict. Moreover, we identified negative associations between emotional burden and mental quality of life and patient perception of chronic illness care and decisional conflict. Understanding these associations will provide valuable insights in the development of targeted interventions to improve quality of life in patients with diabetes.
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Affiliation(s)
- Brigida A Bruno
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dorothy Choi
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Kevin E Thorpe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Catherine H Yu
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada .,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada
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Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol 2019; 56:631-650. [PMID: 30903433 DOI: 10.1007/s00592-019-01295-9] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/02/2019] [Indexed: 02/06/2023]
Abstract
AIMS Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies. METHODS MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11". RESULTS In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%). CONCLUSION Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.
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Affiliation(s)
- Mohammad Khaledi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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de Lima Filho BF, da Nóbrega Dias V, Carlos AG, Fontes FP, de Sousa AGP, Gazzola JM. Factors related to depressive symptoms in older adult patients with type 2 Diabetes Mellitus. Exp Gerontol 2018; 117:72-75. [PMID: 30414438 DOI: 10.1016/j.exger.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 10/27/2018] [Accepted: 11/07/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The association of type 2 Diabetes Mellitus (DM2) with depressive symptoms may affect the quality of life of older adults and increase their risk of morbidity and deterioration in functional activities. This study aimed to investigate the variables related to depressive symptoms in older adult patients with DM2. METHODS This cross-sectional, descriptive, analytical study included 102 older adult patients with DM2, treated in northeastern Brazil. We evaluated demographic, clinical, and functional variables [Timed Up and Go (TUG) test, a scale to assess performance (WHO Disability Assessment Schedule), and psycho-cognitive variables (using the Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS)). RESULTS There was a significant correlation between the GDS and body mass index (p = 0.04, ρ = 0.20) and intensity of pain (p = 0.09, ρ = 0.26); and scores on the MMSE (p = 0.01, ρ = -0.25); WHODAS (p < 0.001, ρ = 0.61); TUG test (p = 0.016, ρ = 0.25), and TUG dual task (p = 0.029, ρ = 0.23). CONCLUSION Depressive symptoms in older adult patients with DM2 were associated with being female, being single, being illiterate, having poor overall health, using a walking aid, having higher body mass index, having a greater intensity of dizziness, exhibiting functional impairment, and having gait and cognition deficits.
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Affiliation(s)
| | - Vanessa da Nóbrega Dias
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil
| | - Adriana Guedes Carlos
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil
| | - Fabieli Pereira Fontes
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil.
| | | | - Juliana Maria Gazzola
- Federal University of Rio Grande Do Norte, University Hospital Onofre Lopes, Natal/Rn 2016, Brazil
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Jeong M, Reifsnider E. Associations of Diabetes-Related Distress and Depressive Symptoms With Glycemic Control in Korean Americans With Type 2 Diabetes. DIABETES EDUCATOR 2018; 44:531-540. [DOI: 10.1177/0145721718807443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Mihyun Jeong
- Department of Nursing, Gyeongju University, Gyeongju, Republic of Korea
| | - Elizabeth Reifsnider
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
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35
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Chen Q, Wang H, Wang Y, Wang Z, Zhao D, Cai Y. Exploring effects of self-management on glycemic control using a modified information-motivation-behavioral skills model in type 2 diabetes mellitus patients in Shanghai, China: A cross-sectional study. J Diabetes 2018; 10:734-743. [PMID: 29457694 DOI: 10.1111/1753-0407.12655] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/24/2018] [Accepted: 02/14/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The original information-motivation-behavioral skills (IMB) model has been verified in type 2 diabetes mellitus (T2DM) patients, but the effects of the model on glycemic control remain unclear. The aim of this study was to modify the IMB model to explore the effects of self-management on glycemic control in T2DM patients in Shanghai, China. METHODS A cross-sectional study was conducted on participants recruited using a convenience sampling method between June and August 2015 in three tertiary hospitals and four community health service centers; 796 participants meeting the inclusion criteria (age ≥18 years and a diagnosis of T2DM) completed a questionnaire and blood test for glycemic control. Structural equation models were used to test the IMB framework. RESULTS The modified model demonstrated an acceptable fit of the data. Paths from information to self-management behaviors (β = 0.119, P = 0.001) and HbA1c (β = -0.140, P < 0.001), from motivation to behavioral skills (β = 0.670, P < 0.001), from behavioral skills to self-management behaviors (β = 0.562, P < 0.001), and from self-management behaviors to HbA1c (β = -0.343, P < 0.001) were all significant and in the predicted direction. Information and motivation varied with each other (r = 0.350, P < 0.001). CONCLUSIONS Glycemic control can be incorporated into the IMB model. The utility of the modified model in the study population is validated. Type 2 diabetes mellitus patients with poor control of glucose levels may be a better target population for application of the modified IMB model.
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Affiliation(s)
- Qi Chen
- Department of Human Resources, Ruijin Hospital, Affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Huwen Wang
- Department of Community Health and Behavioral Medicine, School of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yichen Wang
- Department of Hospital Infection Control, Ruijin Hospital, Affiliated with the School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zezhou Wang
- Department of Community Health and Behavioral Medicine, School of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Daijun Zhao
- Department of Chronic Disease Prevention, Shanghai Hongkou Center for Disease Control and Prevention, Shanghai, China
| | - Yong Cai
- Department of Community Health and Behavioral Medicine, School of Public Health, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Munkhaugen J, Hjelmesæth J, Otterstad JE, Helseth R, Sollid ST, Gjertsen E, Gullestad L, Perk J, Moum T, Husebye E, Dammen T. Managing patients with prediabetes and type 2 diabetes after coronary events: individual tailoring needed - a cross-sectional study. BMC Cardiovasc Disord 2018; 18:160. [PMID: 30075751 PMCID: PMC6091110 DOI: 10.1186/s12872-018-0896-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Understanding the determinants associated with prediabetes and type 2 diabetes in coronary patients may help to individualize treatment and modelling interventions. We sought to identify sociodemographic, medical and psychosocial factors associated with normal blood glucose (HbA1c < 5.7%), prediabetes (HbA1c 5.7-6.4%), and type 2 diabetes. METHODS A cross-sectional explorative study applied regression analyses to investigate the factors associated with glycaemic status and control (HbA1c level) in 1083 patients with myocardial infarction and/or a coronary revascularization procedure. Data were collected from hospital records at the index event and from a self-report questionnaire and clinical examination with blood samples at 2-36 months follow-up. RESULTS In all, 23% had type 2 diabetes, 44% had prediabetes, and 33% had normal blood glucose at follow-up. In adjusted analyses, type 2 diabetes was associated with larger waist circumference (Odds Ratio 1.03 per 1.0 cm, p = 0.001), hypertension (Odds Ratio 2.7, p < 0.001), lower high-density lipoprotein cholesterol (Odds Ratio 0.3 per1.0 mmol/L, p = 0.002) and insomnia (Odds Ratio 2.0, p = 0.002). In adjusted analyses, prediabetes was associated with smoking (Odds Ratio 3.3, p = 0.001), hypertension (Odds Ratio 1.5, p = 0.03), and non-participation in cardiac rehabilitation (Odds Ratio 1.7, p = 0.003). In patients with type 2 diabetes, a higher HbA1c level was associated with ethnic minority background (standardized beta [β] 0.19, p = 0.005) and low drug adherence (β 0.17, p = 0.01). In patients with prediabetes or normal blood glucose, a higher HbA1c was associated with larger waist circumference (β 0.13, p < 0.001), smoking (β 0.18, p < 0.001), hypertension (β 0.08, p = 0.04), older age (β 0.16, p < 0.001), and non-participation in cardiac rehabilitation (β 0.11, p = 0.005). CONCLUSIONS Along with obesity and hypertension, insomnia and low drug adherence were the major modifiable factors associated with type 2 diabetes, whereas smoking and non-participation in cardiac rehabilitation were the factors associated with prediabetes. Further research on the effect of individual tailoring, addressing the reported significant predictors of failure, is needed to improve glycaemic control. TRIAL REGISTRATION Retrospectively registered at ClinicalTrials.gov: NCT02309255 , December 5th 2014.
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Affiliation(s)
- John Munkhaugen
- Department of Medicine, Drammen Hospital, Vestre Viken Health Trust, Dronninggata 41, 3004, Drammen, Norway. .,Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Ragnhild Helseth
- Centre for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Erik Gjertsen
- Department of Medicine, Drammen Hospital Trust, Drammen, Norway
| | - Lars Gullestad
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | | | - Torbjørn Moum
- Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Einar Husebye
- Department of Medicine, Drammen Hospital Trust, Drammen, Norway
| | - Toril Dammen
- Department of Behavioural Sciences in Medicine and Faculty of Medicine, University of Oslo, Oslo, Norway
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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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