Associations Between Diabetes-Related Distress and Cardiovascular Complication Risks in Patients With Type 2 Diabetes and Lower Socioeconomic Status: A Pilot Study

Abstract

sychological health and levels of emotional distress in people with diabetes directly affect their ability to undertake the complicated tasks needed for effective diabetes management. According to the second Diabetes Attitudes Wishes and Needs study (1), quality of life for people with diabetes is negatively affected by this condition; 62.2% of people with diabetes report that diabetes has a negative impact on their physical health (2). People with diabetes are always advised to integrate rigorous diabetes self-care practices into their disease management regimen, leading some to feel burdened with the psychological stress that can accompany the process of accepting the disease and developing ways to integrate its management into their daily life. To address some of this burden, a 2016 American Diabetes Association (ADA) position statement focused on the psychosocial care of individuals with di-abetes, advocating for the assessment of diabetes-related distress (DRD) via validated tools and the integration of appropriate psychological interventions as part of patient-centered care in the primary care setting (3).Psychosocial issues that interfere with patients' diabetes self-care practices and are associated with suboptimal glycemic control include DRD, depression, anxiety, eating disorders, social factors, and cognitive factors. Although DRD is not a proxy to assess clinical depression, it comprehensively summarizes the affective experiences of people living with diabetes, addressing their worries (e.g., the cost and quality of care), concerns (e.g., future diabetes-related complications), and fears (e.g., medication-related adverse outcomes such as hypoglycemia) about having to manage this progressive chronic condition. The DAWN 2 study group, surveying 8,596 adults with diabetes

Diabetes-Related Distress and Associated Characteristics in Patients With Type 2 Diabetes in an Urban Primary Care Setting in Greece

“… 7 Assessing for DRD is important because, for example in patients with type 2 diabetes mellitus (T2D) (which accounts for the 90-95% of the total), recent research indicates that elevated levels of DRD are associated with reduced diabetes self-care, 8 poor medication adherence, 9 presence of depressive symptoms 10 and worse glycaemic outcomes (HbA1c). 8 , 9 More importantly, patients with T2D and higher levels of DRD have increased risk of cardiovascular disease 11 – 13 and lower quality of life. 14 , 15…”

Work-related factors among people with diabetes and the risk of cardiovascular diseases: A systematic review

“…All five studies were conducted in high‐income countries. The geographic region covered the region of the Americas (United States of America), 15 European region (Finland, Sweden), 3 , 16 and Western Pacific region (Singapore, Republic of Korea). 17 , 18 The study design of the included articles was cross‐sectional, comparative cross‐sectional, and cohort study.…”

“…The quality of the included studies was assessed using the JBI critical appraisal checklist for prevalence studies, analytic cross‐sectional studies, and cohort studies. The cross‐sectional study 15 used an appropriate sampling frame, described the study settings in detail, used appropriate and reliable statistical methods. However, the sampling technique was not appropriate, the sample size was not adequate, the analysis did not cover a sufficient proportion of the identified sample, and the response rate was not adequate.…”

“…As per the RoBANS, the selection bias is assessed considering the selection of participants and confounding variables. The selection of participants was graded as high risk of bias in the cross‐sectional studies, 15 , 17 whereas graded as low risk of bias in the cohort studies. 3 , 16 , 18 All five studies measured the confounders and exposures appropriately and were ranked as low risk of bias.…”

“…Yong et al explored the association between diabetic distress and cardiovascular complications in California. 15 The authors used the Nam‐Powers‐Boyd scale to define the occupational status score. They also utilized the PAID (Problem Areas in Diabetes) questionnaire to measure the diabetes‐related distress of the participants.…”