The relationship of diabetes-related distress and depressive symptoms with physical activity and dietary behaviors in adults with type 2 diabetes: A cross-sectional study

Barriers and enablers to engagement with a type 2 diabetes remission project in the North East of England: qualitative perspectives of patients

This qualitative research sought to identify factors influencing patient choice of, and patient-related internal and external enablers and barriers to engagement with, type 2 diabetes (T2D) remission strategies offered by the Remission in diabetes (REMI.D) project. Patients had a choice of three diets: Total Diet Replacement (TDR)-Formula Food Products, TDR-Food, and Healthy lifestyle approach; and three activity pathways: Everyday life, General Practitioner referral, and Social hub. Semi-structured interviews were recorded and transcribed. Thematic analysis used the Framework Method and NVivo 12 to assist with generation and organisation of codes, inductive and deductive (Theoretical Domains Framework). The REMI.D project was a place-based approach (place in this case being defined as two local authorities with significant rates of deprivation) situated in the North East of England. Twenty patients out of a possible 65 patients took part. Areas of interest included: patient choice, patient intention, patient adherence, patient non-adherence, and patient stigma. Addition of a more moderate dietary strategy (not dissimilar to the diet in the Healthier You NHS Diabetes Prevention Programme) to the existing NHS England T2D Path to Remission programme may enable more patients to achieve remission or delayed progression with deprescribing of diabetes medications. Embedding a tailored physical activity path within or as a bolt-on to the NHS programme requires consideration. Limited resources should be targeted towards patients who identify with more barriers or fewer opportunities for health behaviour modification. Further research on use of virtual programmes in deprived areas is warranted.

A novel approach to understanding and assessing the emotional side of type 1 diabetes: The Type 1-Diabetes Distress Assessment System

AIMS

To describe the development of a novel, conceptually sound instrument with contemporary content for assessing diabetes distress (DD) among adults with type 1 diabetes.

METHODS

Qualitative interviews with 15 adults and 7 clinicians were used to develop Core (intensity of DD emotional burden) and primary Source (key DD contributors) items. These were administered to a national sample recruited from the TCOYD Research Registry, T1D Exchange and our previous studies. Exploratory and confirmatory factor analyses were undertaken, along with reliability and construct validity studies, and cut-point analyses to determine elevated DD.

RESULTS

Analyses based on 650 respondents yielded an 8-item Core DD scale (α = 0.95) and 10 2- or 3-item DD Source Scales (α range = 0.53-0.88): Financial Worries, Interpersonal Challenges, Management Difficulties, Shame, Hypoglycemia Concerns, Healthcare Quality, Lack of Diabetes Resources, Technology Challenges, Burden to Others and Worries about Complications. Core and Source scores were significantly associated with criterion variables: Higher DD scores were significantly linked with higher HbA1C, more frequent episodes of severe hypoglycaemia, missed boluses, and poorer quality of life (p > 0.001). A ≥2.0 scale cut-point to define elevated DD is suggested.

CONCLUSIONS

The new T1-Diabetes Distress Assessment System demonstrated good reliability and validity, and with measures of both Core emotional burden and Sources of DD, it provides a contemporary, flexible and practical approach to assessing DD that can be used seamlessly to inform intervention for clinicians and researchers.

Does integrated health management within a county medical consortium improve rural type 2 diabetic patients' self-management behavior and quality of life? An empirical analysis from Eastern China

BACKGROUND

Levels of self-management behaviors (SMB) and quality of life (QoL) are suboptimal in Chinese adults with type 2 diabetes (T2D), especially in rural China. Integrated health management within a county medical consortium, featuring multi-level teams of doctors, nurses, and other professionals offering follow-up services such as check-ups, assessments, treatment, and health education, is promising in improving this. This study aimed to assess the effect of integrated health management within a county medical consortium on the SMB and QoL of rural T2D patients in China.

METHODS

Based on a survey conducted on the county medical consortium in Eastern China, this study initially employed propensity score matching (PSM), a nonparametric technique, to precisely estimate the average treatment effect on the treated (ATT) of integrated health management on SMB and QoL in rural T2D patients. Subsequently, quantile regression was also performed to estimate the relationship between the implementation of integrated health management, sociodemographic factors, follow-up services (offered during integrated health management) and both SMB and QoL.

RESULTS

The ATT values for SMB and QoL, representing the net effect of integrated health management within a county medical consortium on SMB and QoL, were significantly positive. They ranged from 4.34 to 4.67 for SMB and from 0.89 to 1.06 for QoL, respectively, based on the four different PSM modalities. The results of quantile regression also revealed a statistically significant positive association between the implementation of integrated health management and both SMB (coef. = 4.15) and QoL (coef. = 1.54). These findings suggest that integrated health management within a county medical consortium can effectively improve SMB and QoL in rural T2D patients. Furthermore, frequency of follow-up service and health behavior guidance were positively associated with SMB and QoL. Conversely, on-call follow-up services, medication guidance and follow-up services at medical institutions were negatively correlated with SMB or QoL.

CONCLUSIONS

The study highlights the effectiveness of integrated health management within a county medical consortium in improving SMB and QoL among individuals with T2D in rural China. The findings offer invaluable insights for the advancement of chronic disease management in rural areas of developing countries.

Diabetes-related distress and quality of life among people with type 2 diabetes at primary care level in Brazil

PURPOSE

Living with diabetes can be challenging, particularly when it comes to dealing with psychological distress and requiring self-care directives. Patients may feel frustrated, angry, overwhelmed, and discouraged. This study aimed to investigate the diabetes-related distress and quality of life among people with type 2 diabetes mellitus (T2DM).

METHODS

A cross-sectional study carried out at the Clinical Research Centre at the University of Campinas, Brazil, between September 2020 and April 2021. Patients answered data regarding demographic and clinical variables, the Brazilian version of the Diabetes Distress Scale and the Diabetes Quality of Life (QOL) Measure by telephone contact. The data were managed using the RedCap System. For statistical analysis of the data, the Mann-Whitney and Kruskal-Wallis tests were applied for comparisons, and the Chi-square test for associations. The correlations were evaluated using the Spearman correlation coefficient.

RESULTS

Out of the 302 participants we recruited, 50.33% exhibited significant diabetes-related distress. Those with elevated diabetes-related distress scores had shorter education levels (p < 0.05), lower HbA1c levels (p < 0.05), and lower total scores in Diabetes QOL Measure (p < 0.0001), particularly in the QOL impact (p < 0.0001), social/vocational worry (p < 0.05), and diabetes worry (p < 0.0001) subscales compared to the group with the lowest diabetes-related distress.

CONCLUSION

Elevated diabetes-related stress scores significantly affect patients' QOL. Therefore, early screening of individuals at risk for this condition, using well-coordinated protocols, could mitigate adverse QOL effects and enhance their overall experience during disease management.

Social support and diabetes distress: Does the messenger matter as much as the message?

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).

Sedentary Behavior and Physical Activity Associated with Psychosocial Outcomes in Adolescents with Type 1 Diabetes

Background

Adolescents with type 1 diabetes (T1D) are particularly vulnerable to poor psychosocial outcomes-high rates of diabetes distress and poor quality of life are common among this cohort. Previous work in the general population demonstrated positive associations between quality of life and increases in moderate-to-vigorous physical activity (MVPA), as well as decreased sedentary behavior. While survey-based assessments of young adults with T1D observed similar trends, these studies were limited by their use of subjective assessments of MVPA and sedentary behavior. The use of direct activity monitoring is needed to establish the association between psychosocial outcomes and MVPA and sedentary behavior among adolescents with T1D.

Objective

To explore the association between objectively measured MVPA and sedentary behavior on psychosocial outcomes among adolescents with T1D.

Subjects and Methods

The current study is a secondary analysis of baseline data collected for a pilot trial of sleep-promoting intervention for adolescents with T1D. Participants (n = 29, with a mean age of 15.9 ± 1.3 years) completed baseline surveys and wore an actigraph for a week following the baseline visit. We examined minutes per week of MVPA and proportion of awake time spent sedentary in relation to adolescents' diabetes distress, depressive symptoms, and diabetes-related quality of life.

Results

Participants engaged in a mean of 19.6 ± 22.4 minutes of MVPA per day and spent 68.6 ± 9.9% of their awake time sedentary. MVPA was associated with lower diabetes distress in unadjusted (-3.6; 95% CI: -6.4 to -0.8) and adjusted (-2.6; 95% CI: -5.0--0.3) analyses. Sedentary time was associated with higher diabetes distress in adjusted (6.3; 95% CI: 1.3-11.2) but not unadjusted (6.0; 95% CI: -5.6-12.6) analyses. In secondary analyses, we did not observe significant associations between quality of life or depressive symptoms with either MVPA or sedentary behavior.

Discussion

Our findings extend previous survey-based work demonstrating an association between decreased diabetes distress with greater weekly MVPA and lower sedentary time. The current study highlights the multifaceted benefits of physical activity in this population and provides preliminary evidence for developing interventions to reduce sedentary time as an alternative method to improve psychosocial outcomes in this at-risk population.

Gender Impact on Diabetes Distress Focus at Medical Communication Concerns, Life and Interpersonal Stress

INTRODUCTION

along with the rapidly aging population in many countries around the world, the global prevalence of diabetes and suffering from diabetes-related depression have risen in middle-aged and elderly adults. However, given that psychological stress is deeply influenced by culture, gender inequality in these statistics is often exhibited and increases with age. The aim of this study was to explore the gender difference in diabetes distress among middle-aged and elderly diabetic patients.

METHODS

395 participants from four hospitals were recruited for a cross-sectional survey. The Taiwan Diabetes Distress Scale (TDDS) was used to measure diabetes distress. Linear regression was conducted to assess the gender difference in different types of diabetes distress.

RESULTS

there was significant gender difference in each diabetes distress domain. In particular, men who had received diabetes education in the past six months seemed to be more concerned about diabetes complications and felt pressured to communicate with doctors. In addition, women seemed to be more affected by diabetes distress because of their marital status, especially for married women.

CONCLUSIONS

diabetes distress seems to have significant gender differences; however, more longitudinal research is needed on the causal relationship between gender and diabetes distress.

The Influence of the BDNF Val66Met Variant on the Association Between Physical Activity/Grip Strength and Depressive Symptoms in Persons With Diabetes

The rs6265 in the brain-derived neurotrophic factor (BDNF) is associated with depression in people with diabetes. Both physical activity (PA) and grip strength are negatively associated with depression. We conducted cross-sectional analyses of the wave 10 survey data for a nationally representative sample of 1,051 diabetes participants of the Health and Retirement Study. Both greater PA (β = -.15) and stronger grip strength (β = -.02) were independently associated with depression. Although the interaction between BDNF rs6265 and PA on depressive symptoms was not significant, the negative PA-depression association was stronger among female non-Met carriers (β = -.19) and male Met carriers (β = -.14). Meanwhile, grip strength was associated with depression only in Met carriers (β = -.04), and similar association was observed in both males and females. In conclusion, female non-Met carriers and male Met carriers may benefit from PA.

Physical Activity Behavior During the COVID-19 Outbreak in Individuals with Type 2 Diabetes: Role of Social Support and Other Covariates

OBJECTIVES

This study was performed to investigate whether social support and other psychological predictors were associated with physical activity during the prolonged social isolation due to the coronavirus disease 2019 outbreak in Iran.

METHODS

This cross-sectional study was performed on 494 individuals with type 2 diabetes (T2D) in a diabetes specialty clinic. The questionnaire package comprised five parts, including sociodemographic and clinical characteristics, physical activity level, diabetes-specific social support, feelings of isolation, and diabetes-related distress. Clinical and hemoglobin A1c data were obtained from electronic medical records. Descriptive statistics, Pearson's chi-square test, and multivariable logistic regressions were conducted to analyze the data.

RESULTS

Approximately 71% of the participants participated in low/insufficient levels of physical activity. The participants who received support from family/friends (odds ratio [OR] = 1.77; 95% confidence interval [CI]: 1.47 - 2.74), diabetes care team (OR = 1.42; 95% CI: 1.15 - 1.77), and neighbors (OR = 1.53; 95% CI: 1.20 - 2.08) were more likely to have sufficient physical activity than those who did not receive these supports. There was also an association between physical activity behavior with feelings of isolation and diabetes distress.

CONCLUSIONS

This study points to the importance of social support as an amplifier mechanism for the maintenance of physical activity behavior in individuals with T2D during critical times.

Exploring and Developing a New Culturally-Appropriate Diabetes Distress Scale in Taiwan

Introduction

The aim of this study was to develop and validate a new diabetes distress scale suitable for Chinese and Taiwanese culture.

Methods

This study collected the current diabetes distress measurement tools, re-organized current definitions about the domains of diabetes distress, and then developed a new tool. Three hundred and ninety-five participants from four hospitals in northern Taiwan were recruited by cluster randomized sampling for validity test.

Results

We found the new diabetes distress scale had appropriate reliability and validity, including an acceptable model fit for the 12-item scale.

Conclusions

This new diabetes distress scale might be more directly related to emotional distress issues blood glucose control, improve the clinical conspicuity of diabetes distress, and even benefit the overall care of diabetic patients in Taiwan. Further studies about the validity and reliability of this new tool in a nationwide setting are needed.

Prevalence and correlates of diabetes distress and depressive symptoms among individuals with type-2 diabetes mellitus during Ramadan fasting: A cross-sectional study in Bangladesh amid the COVID-19

AIMS

Psychological concerns relating to "diabetes distress" (DD) and depressive symptoms (DS) in individuals with type-2 diabetes mellitus (T2DM) may negatively impact adherence to medical treatments and overall mental health. Thus, this study was undertaken to investigate DS and DD in relation to fasting during the month of Ramadan.

METHODS

A cross-sectional survey was conducted among 735 patients with T2DM in 2021. DD and DS were measured by the Problem Areas in Diabetes scale and Patient Health Questionnaire-9, respectively. Logistic regression and correlation analyses were executed.

RESULTS

More than one-third of the participants (41.2%) had DD and DS (36.9%). DS was significantly higher in participants who did not fast (p = 0.027). Participants who had higher dietary diversity were less likely to have DD (p = 0.004) and DS (p = 0.001). Females (AOR = 1.89, 95% CI: 1.25-2.85) and those who lived alone (AOR = 1.89, 95% CI: 1.25-2.85) were more likely to have DS. Participants with diabetes-related complications were more likely to experience DS (AOR = 2.17; 95% CI: 1.5-3.13) and DD (AOR = 3.46; 95% CI: 2.42-4.95). DD was also associated with being younger (p = 0.003), having hypertension (p = 0.030), having heart disease (p = 0.012), and taking insulin (p = 0.010).

CONCLUSIONS

Individuals with T2DM who were not fasting experienced more mental health concerns. Psychosocial support and other interventions from health professionals should be examined and empirical interventions should be implemented to promote the mental health and well-being of individuals with T2DM.

Factors Associated with Diabetes-Related Distress in Patients with Type 2 Diabetes Mellitus

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.

Roles of Anxiety and Depression in Predicting Cardiovascular Disease Among Patients With Type 2 Diabetes Mellitus: A Machine Learning Approach

Cardiovascular disease (CVD) is a major complication of type 2 diabetes mellitus (T2DM). In addition to traditional risk factors, psychological determinants play an important role in CVD risk. This study applied Deep Neural Network (DNN) to develop a CVD risk prediction model and explored the bio-psycho-social contributors to the CVD risk among patients with T2DM. From 2017 to 2020, 834 patients with T2DM were recruited from the Department of Endocrinology, Affiliated Hospital of Harbin Medical University, China. In this cross-sectional study, the patients' bio-psycho-social information was collected through clinical examinations and questionnaires. The dataset was randomly split into a 75% train set and a 25% test set. DNN was implemented at the best performance on the train set and applied on the test set. The receiver operating characteristic curve (ROC) analysis was used to evaluate the model performance. Of participants, 272 (32.6%) were diagnosed with CVD. The developed ensemble model for CVD risk achieved an area under curve score of 0.91, accuracy of 87.50%, sensitivity of 88.06%, and specificity of 87.23%. Among patients with T2DM, the top five predictors in the CVD risk model were body mass index, anxiety, depression, total cholesterol, and systolic blood pressure. In summary, machine learning models can provide an automated identification mechanism for patients at CVD risk. Integrated treatment measures should be taken in health management, including clinical care, mental health improvement, and health behavior promotion.

Diabetes distress is associated with individualized glycemic control in adults with type 2 diabetes mellitus

PURPOSE

It has been proposed that the negative emotional state of diabetes distress (DD) may exert a detrimental effect on glycemic outcomes of individuals struggling with diabetes-related challenges. Thus far, no study has investigated this association by utilizing individualized treatment targets of patients' glycemic control. Therefore, we sought to identify the potential role of DD in the achievement of individualized glycemic targets (AIGTs) among persons with type 2 diabetes mellitus (T2D).

METHODS

This cross-sectional study included a well-characterized outpatient group of T2D adults cared for in an academic medical center. DD was evaluated with the Diabetes Distress Scale. The AIGTs was defined according to the American Diabetes Association guidelines. Logistic regression analyses were utilized to identify independent correlates of the AIGTs.

RESULTS

A total of 123 individuals (mean [standard deviation] age: 58.0 [6.2] years, 55.3% females) were included in the final analysis. AIGTs was observed in 43.9% of the patients. Experiencing greater DD was associated with a lower likelihood of AIGTs (unadjusted odds ratio [OR]: 0.17, 95% confidence interval [CI]: 0.08-0.34, P value < 0.001), even after accounting for additional individual-level covariates (adjusted OR: 0.18, 95% CI: 0.08-0.42, P value < 0.001). Medication adherence was also a determinant of participants' AIGTs (adjusted OR: 1.91, 95% CI: 1.13-3.23, P value = 0.015).

CONCLUSION

Our findings provide novel evidence that DD likely undermines glycemic status in adult outpatients with T2D, even in the context of individually tailored diabetes care, and this should be taken into account when necessary.

Effect of Study Design and Survey Instrument to Identify the Association Between Depressive Symptoms and Physical Activity in Type 2 Diabetes, 2000-2018: A Systematic Review

Introduction

Previous studies have used a variety of survey measurement options for evaluating the association between physical activity (PA) and depressive symptoms, raising questions about the types of instruments and their effect on the association. This study aimed to identify measures of PA and depressive symptoms and findings of their association given diverse instruments and study characteristics in type 2 diabetes (T2DM).

Methods

Online databases, Medline, Embase, CINAHL, and PsycINFO were searched on July 20, 2018, and January 8, 2019. Our systematic review included observational studies from 2000 to 2018 that investigated the association between PA and depressive symptoms in T2DM.

Results

Of 2294 retrieved articles, 28 studies were retained in a focused examination and comparison of the instruments used. There were a range of standard measures, 10 for depressive symptoms and 7 for PA, respectively. Patient Health Questionnaire (PHQ) for depressive symptoms and study-specific methods for PA were the most popular. Overall, 71.9% found a significant association between PA and depressive symptoms. Among studies classified as high quality or reliability, the figure was 81.8%.

Conclusion

A majority of the sample found an association between depressive symptoms and PA, which is fairly consistent across study characteristics. The findings provide the evidence for the health benefits of PA on reducing depressive symptoms in persons with T2DM, suggesting active engagement in PA for effective diabetes management. However, guidelines for objective measurements and well-designed prospective studies are needed to strengthen the evidence base and rigor for the association and its directionality.

The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies

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.

The role of concordant and discordant comorbidities on performance of self-care behaviors in adults with type 2 diabetes: a systematic review

Background: Most patients with Type 2 diabetes (T2D) have high number of comorbid chronic conditions that can affect their self-care abilities. Guidelines for diabetes self-care behaviors are disease specific with little attention given to managing T2D with other comorbidities. Identifying comorbidities that either improve or potentially diminish the individual's capacity to perform effective self-care behaviors is essential to enhance clinical outcomes. One such framework conceptualizes comorbidities as concordant or discordant with diabetes pathophysiological pathways and care goals. Objective: The purpose of this systematic review was to examine the role of diabetes-concordant and discordant chronic conditions on the performance of self-care behaviors in adults with T2D. Methods: A comprehensive literature search was undertaken to identify published English language articles through the following five electronic databases: PubMed, CINAHL, PsycINFO, ISI Web of Science, and EMBASE. Quantitative studies published from March 2006 to April 2018 were included. Quality of evidence was evaluated using the Joanna Briggs Institutes Critical Appraisal Tools (JBI-CAT) and rated using Quality Assessment Tool for Quantitative Studies (QATQS). Results: The initial database search identified 1,136 articles but only 33 studies that met the inclusion criteria were included. The most common concordant comorbidity was hypertension while depression was the most common discordant condition. Adherence to medications was the most frequent diabetes self-care behavior reported and tended to be higher among concordant comorbidities. The findings showed mixed results concerning the effect of some concordant comorbidities such as hypertension, hyperlipidemia, retinopathy, and heart failure on diabetes self-care behaviors. But, there is agreement across studies that diabetes-discordant comorbidities have a more detrimental effect on self-care behaviors. Conclusions: Concordant comorbidities may improve diabetes self-care, but the evidence is inconclusive. Future research using well designed studies are needed to examine the complex relationship between diabetes self-care and comorbidities.

Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus

Objective:

To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients.

Methods:

A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS).

Results:

About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The "emotional burden", "regimen-related distress", and "interpersonal distress" domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175).

Conclusion:

These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study.

Objetivo:

Avaliar a relação entre o estresse relacionado ao diabetes e as características clínicas e sociodemográficas de pacientes com diabetes mellitus do tipo 2.

Métodos:

Estudo transversal com base na análise secundária de dados coletados em um ambulatório de atendimento terciário no Brasil. Os participantes preencheram um questionário sobre as características sociodemográficas e clínicas, e a versão brasileira da Diabetes Distress Scale (B-DDS).

Resultados:

Aproximadamente 31% dos 130 pacientes elegíveis relataram estresse relacionado ao diabetes, e a média do escore da B-DDS foi de 2,6. O modelo de regressão múltipla mostrou que a pontuação B-DDS foi positivamente correlacionada com o estado civil (p=0,0230), realização de dieta e atividades físicas (p=0,0180), e uso de insulina (p=0,0030). Os domínios da B-DDS "carga emocional", "estresse relacionado ao regime terapêutico" e "estresse nas relações interpessoais" foram associados a uso de insulina (p=0,0010), estado civil (p=0,0110) e presença de três ou mais comorbidades (p=0,0175).

Conclusão:

Estes resultados sugerem que as variáveis clínicas e sociodemográficas são preditores relativamente fracos para o estresse relacionado ao diabetes. No domínio "carga emocional", foi observada a maior pontuação da B-DDS, indicando a presença do estresse relacionado ao diabetes entre os pacientes deste estudo.