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Salawati E. Mental Wellbeing and Quality of Life Among Patients With Diabetes Suffering From Hypoglycaemia in Saudi Arabia. Cureus 2021; 13:e17586. [PMID: 34646639 PMCID: PMC8481740 DOI: 10.7759/cureus.17586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 11/05/2022] Open
Abstract
Background Diabetes mellitus is a global burden that is considered a major public health concern for many countries. Saudi Arabia is ranked second among the highest percentages of diabetes worldwide, with more than 7 million patients with diabetes reported in 2017, with an estimated prevalence to be around 14%. Psychological and mental health outcomes are poorer in patients with diabetes who are suffering from hypoglycaemia. The aim of the study was to investigate the mental wellbeing and quality of life of patients with diabetes suffering from hypoglycaemia in Saudi Arabia. Methods A cross-sectional study using an online self-administered questionnaire was conducted between the 13th of June and the 19th of July 2021 in Saudi Arabia. Results A total of 69.7% of the study participants scored below 13 on the WHO-5 scale, which indicates poor mental wellbeing status and possible depression, and reduced quality of life. A total of 67.8% of the study participants scored equal to or greater than 8 on the PAID-5 scale, which indicates possible diabetes-related emotional distress that warrants further assessment. The majority of the study participants (83.4%) scored equal to or greater than 28 on the fear of hypoglycaemia scale, which is classified as having fear of hypoglycaemia. Conclusion Depressive symptoms and reduced quality of life are common among patients with diabetes mellitus suffering from hypoglycaemia in Saudi Arabia.
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Affiliation(s)
- Emad Salawati
- Family Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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2
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Kao KL, Sung FC, Tzang RF, Huang HC, Lin CL, Fang CK, Wu SI, Stewart R. Associations of diabetes severity and risk of depression: a population-based cohort study. J Affect Disord 2020; 273:476-481. [PMID: 32560943 DOI: 10.1016/j.jad.2020.04.066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Previous literature investigating effects of diabetes complications on subsequent depression have been inconsistent. We aim to investigate associations of diabetes, complication severity, and depression. DESIGN This study used a nationwide database to establish an 11-year cohort comprised of people with new onset Type II diabetes mellitus (DM) aged 20 and above. METHOD Severity of DM was measured using the adapted Diabetes Complication Severity Index (aDCSI). Status of depression was determined by having one recorded depression diagnosis from the inpatient setting or three recorded depression diagnoses from the outpatient setting. The risk of depression was analyzed by multivariate Cox proportional models. RESULTS In 50,590 cases with new onset DM from years 2000 to 2011, the incidence of depression increased with severity and rates of progressions in diabetes complications regardless of demographic status, comorbidities, or medication compliance. Adjusted hazard ratios (aHR) of depression were 1.21, 1.25, 1.48 (p<0.001 for trend) in patients with a total aDCSI score of 1, 2, and > 3, respectively. Risks of depression were the highest in subgroup with the most serious progression (change of aDCSI score >2 per year) (aHR ranged between 11.6~26.0). Elevated risks of depression (aHR: 1.59~4.36) were also observed in the slower progression subgroups throughout the disease course. CONCLUSIONS Risks of depression were associated with multiple DM-related complications and rates of progression in severity.
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Affiliation(s)
- Kai-Liang Kao
- Far Eastern Memorial Hospital, Department of Pediatrics, Taipei, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University, College of Public Health, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ruu-Feng Tzang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Section of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Hui-Chun Huang
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Chun-Kai Fang
- Section of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shu-I Wu
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Section of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
| | - Robert Stewart
- King's College London (Institute of Psychiatry, Psychology & Neuroscience), Department of Psychological Medicine, London, UK
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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: 12] [Impact Index Per Article: 3.0] [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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Al-Ozairi E, Al Ozairi A, Blythe C, Taghadom E, Ismail K. The Epidemiology of Depression and Diabetes Distress in Type 2 Diabetes in Kuwait. J Diabetes Res 2020; 2020:7414050. [PMID: 32566681 PMCID: PMC7288194 DOI: 10.1155/2020/7414050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 04/29/2020] [Accepted: 05/14/2020] [Indexed: 11/24/2022] Open
Abstract
This study is aimed at describing the prevalence of and risk factors for depression and diabetes distress in people with type 2 diabetes and whether depression and distress are independently associated with worse biomedical outcomes. The study was of cross-sectional design. The setting was the Dasman Diabetes Institute, Kuwait. The Patient Health Questionnaire-9 (PHQ-9) was used to measure the prevalence of depression, defined as a score ≥ 10 (depression caseness). The Problem Areas in Diabetes (PAID) was used to measure diabetes-related distress. Data on biomedical outcomes, lifestyle factors, and sociodemographic information were collected. The prevalence of depression and diabetes distress caseness was 29% and 14%, respectively. Depression caseness patients were more likely to be female (60%; p = 0.001), have Kuwaiti nationality (68%, p = 0.121), were on insulin (67%, p = 0.001), have higher body mass index (p = 0.047), were less physically active (78%; p = 0.034), have a higher PAID score (p < 0.001), and have hypertension (74%, p = 0.047). After adjustment of sociodemographics (age, gender, and marital status) and body mass index, the prevalence of depression was associated with higher HbA1c (B = 0.04, 95% confidence interval 0.01 to 0.60), while diabetes distress had a weak association with HbA1c (B = 0.13, 95% confidence interval 0.04 to 0.22). In conclusion, people with type 2 diabetes in Kuwait have a high prevalence of depression but lower diabetes distress and this was associated with worse glycaemic control.
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Affiliation(s)
- Ebaa Al-Ozairi
- Dasman Diabetes Institute, Kuwait
- Faculty of Medicine, Kuwait University, Kuwait
| | - Abdulla Al Ozairi
- Department of Psychiatry, Faulty of Medicine, Kuwait University, Kuwait
| | - Clare Blythe
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Khalida Ismail
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Li J, Qiu X, Yang X, Zhou J, Zhu X, Zhao E, Qiao Z, Yang Y, Cao D. Relationship between Illness Perception and Depressive Symptoms among Type 2 Diabetes Mellitus Patients in China: A Mediating Role of Coping Style. J Diabetes Res 2020; 2020:3142495. [PMID: 33123596 PMCID: PMC7585654 DOI: 10.1155/2020/3142495] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The aims of the present study were to investigate the prevalence of depressive symptoms among type 2 diabetes mellitus (T2DM) patients in China and to explore how coping style influences the relationship between illness perception and depressive symptoms. METHODS Nine hundred and thirty-nine T2DM patients were recruited from a grade 3 Class A hospital in Harbin, China, and asked to complete a demographic questionnaire as well as the Self-rating Depression Scale (SDS), Brief Illness Perception Questionnaire-Revised (IPQ-R), and Medical Coping Modes Questionnaire (MCMQ). Hierarchical linear regression analysis and the bootstrap method were preformed to examine if coping style influenced the relationship between illness perception and depression. RESULTS The majority of patients (73.59%) exhibited depressive symptoms, including 37.27% with moderate and 6.71% with severe depressive symptoms. Depressive symptoms were more frequent in patients with complications (P < 0.05). A resignation coping style partially mediated the influence of illness perception on depressive symptoms. CONCLUSIONS Interventions to improve coping style may reduce the prevalence or severity of depressive symptoms among T2DM patients, potentially enhancing treatment adherence and clinical outcome.
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Affiliation(s)
- Jiarui Li
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
| | - Xiaohui Qiu
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
| | - Xiuxian Yang
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
| | - Jiawei Zhou
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
| | - Xiongzhao Zhu
- Medical Psychological Institute of the Second Xiangya Hospital of Central South University, Hunan Province, China
| | - Erying Zhao
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
| | - Zhengxue Qiao
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
| | - Yanjie Yang
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
| | - Depin Cao
- Department of Medical Education Management, Public Health Institute of Harbin Medical University, Heilongjiang Province, China
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Rariden C. Diabetes Distress: Assessment and Management of the Emotional Aspect of Diabetes Mellitus. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2019.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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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: 167] [Impact Index Per Article: 33.4] [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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McGill DE, Volkening LK, Pober DM, Muir AB, Young-Hyman DL, Laffel LM. Depressive Symptoms at Critical Times in Youth With Type 1 Diabetes: Following Type 1 Diabetes Diagnosis and Insulin Pump Initiation. J Adolesc Health 2018; 62:219-225. [PMID: 29212599 PMCID: PMC5803334 DOI: 10.1016/j.jadohealth.2017.09.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE Depressive symptoms occur at various times during the life cycle in persons with type 1 diabetes. We investigated depressive symptoms prospectively in youth with new-onset type 1 diabetes and in those beginning pump therapy. METHODS Youth with type 1 diabetes (N = 96), ages 10-17 years, completed the Children's Depression Inventory (CDI) at baseline and at 1, 6, and 12 months after diabetes onset or pump start; scores ≥13 indicated clinical elevation. The change in depressive symptoms and the association between CDI score and hemoglobin A1c (HbA1c) level were assessed over 1 year. RESULTS The new-onset group (n = 54) had an HbA1c level of 11.4% ± 2.5%. The pump group (n = 42) had a diabetes duration of 4.1 ± 3.4 years and an HbA1c level of 8.3% ± 1.3%. The baseline median CDI was 5.0 in both groups and remained low over time (ranging from 2.0 to 3.5). Most youth (new onset 72%, pump 81%) scored <13 at all times. Those with a CDI score of ≥13 in month 1 had 9-fold (95% confidence interval: 3-28) and 11-fold (95% confidence interval: 3-38) higher risks of CDI score of ≥13 at 6 and 12 months, respectively, than those with a CDI score of <13. New-onset youth with a CDI score of ≥13 in month 1 had a higher HbA1c level at 6 months (8.3% ± 1.7%) than new-onset youth with a CDI score of <13 (7.2% ± 1.6%, p = .04). CONCLUSIONS CDI scores over 1 year were similar in the new-onset and pump groups. Youth with elevated CDI in the first month after diagnosis or pump start were significantly more likely to have a CDI score of ≥13 at 6 or 12 months, supporting recommendations to screen for depressive symptoms because of persistence over time. Those with new-onset diabetes and depressive symptoms in the first month had higher HbA1c at 6 months; confirmatory research is needed.
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Affiliation(s)
- Dayna E. McGill
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Lisa K. Volkening
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - David M. Pober
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - Andrew B. Muir
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA
| | | | - Lori M. Laffel
- Section on Clinical, Behavioral, and Outcomes Research, Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA
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9
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The earlier the better: health-related quality of life is inversely related to age of smoking cessation in older former Italian smokers. Aging Clin Exp Res 2017; 29:655-663. [PMID: 27456679 DOI: 10.1007/s40520-016-0608-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Quitting smoking has several health benefits, including an improvement in health-related quality of life. It is not well established if there is a relationship between the age when people stop smoking and health-related quality of life in older adults. AIMS The primary aim was to investigate the relationship between health-related quality of life and the age when people quit smoking in a national representative sample of community-dwelling older Italian adults. The secondary aim was to describe the characteristics of older former smokers according to their age when they stopped smoking. METHODS Data were drawn from the "Health and use of health care in Italy", a national cross-sectional survey (2004-2005). Seven thousand five hundred and sixty-two former smokers, aged 65 years and older, were evaluated by age of smoking cessation. Socio-demographic characteristics, physical activity, the 12-Item Short-Form Health Survey (SF-12) score and its physical (PCS-12) and mental (MCS-12) component summary scores, disability and comorbidities were analyzed. RESULTS Educational level, marital status and area of residence were associated with a different age of smoking cessation, as a higher level of disability and comorbidity. PCS-12 (β -0.144; p < 0.001) and MCS-12 (β -0.077; p < 0.001) component scores were lower in subjects who quit smoking later. The relationship was confirmed for the PCS-12 score even after adjustment for socio-demographic, disability and clinical variables (β -0.031; p < 0.001), while it disappeared for the MCS-12 score (β -0.010, p = 0.307), after adjustment for comorbidities. CONCLUSION Physical and mental health-related quality of life is influenced by the age of smoking cessation in older individuals, but this relationship is influenced by comorbidities, particularly depression. Some individual characteristics are related to the age of the person when he/she quit smoking.
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Berry E, Davies M, Dempster M. Illness perception clusters and relationship quality are associated with diabetes distress in adults with Type 2 diabetes. PSYCHOL HEALTH MED 2017; 22:1118-1126. [PMID: 28103702 DOI: 10.1080/13548506.2017.1281976] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This report aims to augment what is already known about emotional distress in Type 2 diabetes, by assessing the predictive value of illness perception clusters and relationship quality on four subcategories of Diabetes Distress.162 individuals with Type 2 diabetes responded to a postal questionnaire assessing demographics, depression, diabetes distress, illness perceptions and relationship quality. Long-term blood glucose was retrieved from participants' General Practitioner. Three illness perception clusters emerged from the data, capturing three subgroups of participants sharing similar illness perception schemas. Regression analyses were performed across each diabetes distress subscale, with demographics, illness perception clusters, and relationship variables entered into three blocks. Covariates explained 51.1% of the variance in emotional burden, 41% of the variance in regimen-related distress, 20% of the variance in interpersonal distress, and 8.6% of the variance in physician-related distress. Cluster membership was strongly associated with emotional burden, regimen-related distress, and to a lesser degree interpersonal distress, but was not associated with physician-related distress. Relationship quality most strongly predicted regimen-related distress. Illness perception schemas and interpersonal issues influence emotional adjustment in diabetes. This study provides direction for the content of a novel approach to identifying and reducing diabetes distress in people with Type 2 diabetes.
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Affiliation(s)
- Emma Berry
- a School of Psychology, Queen's University Belfast , Belfast , UK
| | - Mark Davies
- b Clinical Psychology , Belfast City Hospital , Belfast , UK
| | - Martin Dempster
- a School of Psychology, Queen's University Belfast , Belfast , UK
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Chew BH, Vos R, Mohd-Sidik S, Rutten GEHM. Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia. PLoS One 2016; 11:e0152095. [PMID: 27002728 PMCID: PMC4803274 DOI: 10.1371/journal.pone.0152095] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 03/08/2016] [Indexed: 02/08/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS), and depression (Patient Health Questionnaire, PHQ). Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results (< 3 months) were consecutively recruited. Associations between DRD, depression and the combination DRD-depression with demographic and clinical characteristics were analysed using generalized linear models. From 752 invited people, 700 participated (mean age 56.9 years, 52.8% female, 52.9% Malay, 79.1% married). Prevalence of DRD and depression were 49.2% and 41.7%, respectively. Distress and depression were correlated, spearman's r = 0.50. Patients with higher DRD were younger (OR 0.995, 95% CI 0.996 to 0.991), Chinese (OR 1.2, 95% CI 1.04 to 1.29), attending Dengkil health clinic (OR 1.1, 95% CI 1.00 to 1.22) and had higher scores on the PHQ (OR 1.1, 95% CI 1.04 to 1.06). Depression was less likely in the unmarried compared to divorced/separately living and those attending Dengkil health clinic, but more likely in patients with microvascular complications (OR 1.4, 95% CI 1.06 to 1.73) and higher DDS (OR 1.03, 95% CI 1.02 to 1.03). For the combination of DRD and depression, unemployment (OR 4.7, 95% CI 1.02 to 21.20) had positive association, whereas those under medical care at the Salak health clinics (OR 0.28, 95% CI 0.12 to 0.63), and those with a blood pressure > 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89) were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary care level. Socio-demographic more than clinical characteristics were related to DRD and depression.
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Affiliation(s)
- Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of General Practice, Huispost Str.6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
- * E-mail:
| | - Rimke Vos
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of General Practice, Huispost Str.6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Guy E. H. M. Rutten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Department of General Practice, Huispost Str.6.131, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
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12
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Berry E, Lockhart S, Davies M, Lindsay JR, Dempster M. Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies. Postgrad Med J 2015; 91:278-83. [PMID: 25827438 DOI: 10.1136/postgradmedj-2014-133017] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 03/06/2015] [Indexed: 11/04/2022]
Abstract
Diabetes distress is a rational emotional response to the threat of a life-changing illness. Distinct from depression, it is conceptually rooted in the demands of diabetes management and is a product of emotional adjustment. Diabetes distress has been found to be significantly associated with glycated haemoglobin (HbA1c) level and the likelihood of an individual adopting self-care behaviours. The lack of perceived support from family, friends and healthcare professionals significantly contributes to elevated diabetes distress, and this issue tends to be overlooked when designing interventions. Pioneering large-scale research, DAWN2, gives voices to the families of those with diabetes and reaffirms the need to consider psychosocial factors in routine diabetes care. Structured diabetes education programmes are the most widely used in helping individuals cope with diabetes, but they tend not to include the psychological or interpersonal aspects of diabetes management in their curricula. The need for health practitioners, irrespective of background, to demonstrate an understanding of diabetes distress and to actively engage in discussion with individuals struggling to cope with diabetes is emphasised.
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Affiliation(s)
- Emma Berry
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - Sam Lockhart
- School of Medicine, Dentistry and Biological Science, Queen's University Belfast, Belfast, UK
| | - Mark Davies
- Department of Clinical Psychology, Belfast City Hospital, Belfast, UK
| | - John R Lindsay
- Department of Diabetes and Endocrinology, Mater Infirmorum Hospital, Belfast, UK
| | - Martin Dempster
- School of Psychology, Queen's University Belfast, Belfast, UK
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Oliveira RA, Tostes M, Queiroz VA, Rodacki M, Zajdenverg L. Insulin mediated improvement in glycemic control in elderly with type 2 diabetes mellitus can improve depressive symptoms and does not seem to impair health-related quality of life. Diabetol Metab Syndr 2015; 7:55. [PMID: 26110026 PMCID: PMC4478689 DOI: 10.1186/s13098-015-0052-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 06/16/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Type 2 diabetes (T2D) is very prevalent among the elderly. Insulin therapy is often required for glycemic control. The association of starting this therapy with depressive symptoms as well the health-related quality of life (HRQoL) is unknown among the elderly patients. AIMS Evaluate the association of starting insulin therapy depressive symptoms as well with HRQoL of elderly people with T2D. METHODS 36 T2D participants (67.9 % females, age 66.5 years ± 5.1) were recruited, 26 of whom completed the follow-up. Generic (Short-Form 36 Health Survey - SF-36) and specific (Problem Areas in Diabetes - PAID) HRQoL questionnaires, Beck Depression Inventory (BDI), clinical, laboratorial and socio-demographic data were recorded on baseline and 6 months after the beginning of insulin treatment. RESULTS There was a reduction in the BDI score after the use of insulin, which means an improvement in depressive symptoms (Before/After: median - 10.5 / 7; p = 0008). There were no statistically significant differences in HRQoL scores between the two time periods There was also a reduction in HbA1c (Before/After: median - 8.7/7.9). Otherwise, there were no statistically significant differences in: BMI (28.1/28.3); Abdominal circumference:(100.5/99.5) and chronic complications status. CONCLUSION Insulin therapy in elderly people with type 2 diabetes can lead to an improvement of depressive symptoms and does not seem to affect negatively HRQoL of the participants.
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Affiliation(s)
- R. A. Oliveira
- Nutrology and Diabetes Section, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - M. Tostes
- Nutrology and Diabetes Section, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - V. A. Queiroz
- Nutrology and Diabetes Section, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - M. Rodacki
- Nutrology and Diabetes Section, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - L. Zajdenverg
- Nutrology and Diabetes Section, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Jansen HJ, Vervoort GMM, de Haan AFJ, Netten PM, de Grauw WJ, Tack CJ. Diabetes-related distress, insulin dose, and age contribute to insulin-associated weight gain in patients with type 2 diabetes: results of a prospective study. Diabetes Care 2014; 37:2710-7. [PMID: 25011948 DOI: 10.2337/dc13-1205] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The determinants of insulin-associated weight gain in type 2 diabetes mellitus (T2DM) are partly unknown. Therefore, we conducted a prospective study to identify predictors of insulin-associated weight gain. RESEARCH DESIGN AND METHODS In patients with T2DM, we assessed physical activity by accelerometry and measured diabetes-related distress by questionnaires before and 6 and 12 months after starting insulin therapy. Glycemic control (HbA1c) and insulin dose were monitored. RESULTS After 12 months of insulin therapy, mean body weight had increased by 3.0 ± 2.5 kg (P < 0.001). The drop in HbA1c was correlated with insulin-associated weight gain. With the use of a multiple linear regression model, a cluster of variables was identified that significantly related to weight gain. Diabetes-related distress, initial insulin dose, and the increase of insulin dose during the course of the study as well as age appeared to be important predictors of weight gain after initiation of insulin therapy. Physical activity (measured as MET) decreased from 1.40 ± 0.04 at baseline to 1.32 ± 0.04 MET (P < 0.05) but was not significantly related to weight changes. CONCLUSIONS Diabetes-related distress, initial and titration of insulin dose, and age all significantly predict insulin-associated weight gain. After the initiation of insulin therapy, physical activity decreased significantly, but this did not determine weight gain over the first 12 months. Our study findings may have clinical implications.
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Affiliation(s)
- Henry J Jansen
- Department of Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Gerald M M Vervoort
- Department of Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Anton F J de Haan
- Biostatistics Group, Department for Health Evidence, Radboud University, Nijmegen, the Netherlands
| | - Paetrick M Netten
- Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Wim J de Grauw
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands Family Practice Berghem, Berghem, the Netherlands
| | - Cees J Tack
- Department of Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
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