Diabetes distress (DD) represents a significant clinical burden in which levels of DD are related to both HbA1c and some self-management behaviours. DD is related to, but different from, depression.Differences in DD experienced in people with type 1 and type 2 have been observed. Commonly measured by the Problem Areas in Diabetes Scale and the Diabetes Distress Scale, rates of elevated DD in research study participants range 20-30%. Risk factors for elevated DD in type 1 are a longer duration of diabetes, severe hypoglycaemia, younger age and being female. A systematic review of intervention studies assessing DD identified eight RCTs and nine pre-post design studies. Only three studies targeted DD with the intervention. Intervention types were diabetes self-management education (DSME); psychologically informed self-management and; devices. DSME pre-post studies, namely the DAFNE programme (Dose Adjustment For Normal Eating), produced more consistent improvements in DD and HbA1c at follow up. Psychologically informed self-management were more heterogeneous but several RCTs were effective in reducing DD. Group interventions offered the greatest benefits across intervention designs.
The flexible GSD intervention benefitted younger adult women by significantly improving glycaemic control and decreasing diabetes related distress. No effect was seen among men.
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