Background Diabetes-related distress (DRD) refers to negative emotional and affective experiences from daily demands of living with diabetes. People who received social support seem less likely to experience DRD. The prevalence of T2D in Vietnam is rapidly increasing. Yet, DRD and its association with social support have not been investigated. This study investigates DRD and how it is associated with unmet needs for social support in people with T2D in Thai Binh Province, Vietnam. Methods A total of 806 people, age ≥ 40 years, treated for T2D at primary hospitals in Thai Binh Province, Vietnam, completed a questionnaire-based cross-sectional survey. DRD was self-reported, based on the Problem Areas In Diabetes scale 5 (PAID5). We assessed 6 types of unmet needs for social support from family/friends/community including: (i) Transport and company when visiting health facilities; (ii) Reminders to take medication; (iii) Purchase and preparation of food; (iv) Reminders to engage in physical exercise; (v) Emotional support; and (vi) Financial support. Multivariable logistic regression was used to model DRD as an outcome of each type of unmet need for social support, and as an outcome of the number of unmet needs for social support, adjusted for three sets of covariates. Results In this study, 50.0% of people with T2D experienced DRD. Odds for DRD were higher among those who had any unmet need for social support. After adjustment for household economic status, only unmet needs for emotional and financial support were associated with higher odds ratios of DRD (OR = 2.59, CI95%: 1.19–5.63 and OR = 1.63, CI95%: 1.10–2.40, respectively). People who had ≥2 type of unmet need were not a higher risk of experiencing DRD as compared to those with no unmet need. Conclusions Half of the people with T2D experienced DRD. The results suggest that having enough finances may decrease most needs for social support with the exception of emotional support. Thus, social support to financial and emotional of diabetes aspects may contribute to prevent or reverse DRD.

Objective The prevalence of diabetes has been rising in rural areas of Vietnam over the last years to the extend where it has become a public health burden. Individuals with diabetes-related distress (DRD) is in greater risk of adverse health outcomes e.g. lower blood sugar control and polypharmacy. The objective of this study is to assess the association between hypertension and cardiovascular disease (CVD) and the occurrence of DRD among individuals with type 2 diabetes (T2D) in rural areas of Vietnam. Method This is a cross-sectional study of 806 individuals who had been receiving treatment for T2D at a district hospital in the northern Vietnamese province Thai Binh. Based on self-reported data DRD was assessed through Problem Areas in Diabetes scale 5 (PAID5) and defined as a score of 8 or above. The occurrence of the comorbid conditions hypertension and CVD were self-reported. Results Among 806 individuals with T2D 37.7% of the men and 62.3% of the women presented with DRD. Out of the total group 35.6% reported hypertension, 7.3% reported CVD and 21.2% reported a combination of hypertension and CVD. The results of the multivariate analyses showed that the odds ratio of DRD was significantly higher (OR=1.67, CI95: 1.11-2.52) in the group who reported a combination of hypertension and CVD. Conclusion Among individuals with T2D in rural areas of Vietnam there is an increased risk of DRD if a combination of hypertension and cardiovascular disease is also present. Hence, considering diabetes-related comorbidities can be useful in order to successfully identify individuals in risk of DRD.

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BACKGROUND From a diabetes management perspective, informal care has proven at least as important as care from health professionals when targeting poorly controlled diabetes. The objective of this study was to identify determinants associated with unmet needs for informal support among people with type-2 diabetes in rural communities of Vietnam. METHODS A cross-sectional survey was conducted from December 2018 to February 2019 in a rural area of northern Vietnam. From 2 districts in Thai Binh Province, Vietnam, 806 people with type-2 diabetes participated in a survey designed to assess who were their most important informal caregivers (ICGs) and to measure the association between demographic and socio-economic predictors and unmet needs of informal support of relevance for diabetes self-care using bivariate and multivariate analyses. RESULTS The spouse was reported as the most important ICG (62.9%) followed by a daughter or son (28.4%). 32.0% of the people with type-2 diabetes reported at least one type of unmet need for informal support. The most commonly reported unmet needs of informal care were: transport to health facilities and company when seeking formal care (20.5%), financial support related to costs of diabetes self-management (18.5%), and reminders to engage in physical exercise (14.5%). People living alone reported the highest odds ratio (OR) for unmet need of informal care (OR=4.41; CI95%: 2.19-8.88), followed by those being poor as compared to being wealthy (OR=3.79; CI95%: 1.25-11.52) and those being unemployed as compared to being retired (OR=2.85; CI95%: 1.61-5.05). CONCLUSIONS Almost one-third of people with type-2 diabetes reported at least one type of unmet need for informal care. These findings provide a basis for development of new modalities for strengthening support provided by ICGs in rural communities in Vietnam and in other low- and middle-income countries.