Diabetes-Related Distress Assessment among Type 2 Diabetes Patients

Abstract

Background and Objectives Diabetes is one of the most common chronic diseases; it is a debilitating and hard to live with. Diabetes-related distress (DRD) refers to the emotional and behavioral changes caused by diabetes. Our study aims to assess the prevalence of DRD among type 2 diabetes (T2D) patients using Diabetes Distress Scale-17 items (DDS-17) and its relation to complications and treatment modalities. Methods A cross-sectional study of adult T2D patients with follow-up visits at the Diabetes and Endocrinology Center in Taif, Saudi Arabia, between January and July 2017. We excluded patients with other forms of diabetes, untreated hypothyroidism, and psychiatric illness. The total score of DDS-17 was calculated by summing the 17 items' results and then dividing the total by 17. If the total score was >2, then it was considered as clinically significant results (moderate distress), but if it is ≥3, then it is classified as a high distress. Results A total of 509 T2D patients with a mean age of 58 ± 14 years were included. The majority of participants were male, married, not college educated, and reported a sedentary lifestyle. We found 25% of the screened T2D patients have moderate to high DRD. Regarding the DRD components, emotional distress was the most prevalent followed by physician-related distress. HabA1c was significantly higher in those with high combined distress and high emotional distress compared to those with mild/moderate distress (p = 0.015 and 0.030, resp.). Conclusion Our study shows that DRD is a medically relevant issue that clinicians need to address. Despite observing a low prevalence of DRD compared to other studies, we found significant correlations between DRD scores and HabA1c, triglyceride levels, BMI, T2D duration, and interval between visits.

Type 2 Diabetes Mellitus Related Distress in Thailand

“…The results of the present study are consistent with those of Zhou et al, which reported that the total DDS score was not significantly related to patients' gender, age, diabetes duration, diabetes education, or complications [38]. On the other hand, other studies have reported that DRD is associated with age, duration of diabetes, occupation, marital status, glycemic status, treatment modalities, comorbidity, and diabetic complications [25,41,42]. These findings suggest that there may be other factors which affect DRD, e.g., type of diabetes, treatment regimen, and socioeconomic factors [21].…”

“…However, another German study conducted at the primary care level reported only a 1.2% prevalence of DRD using the PAID scale [39,40]. The differences in DRD prevalence might result from differences in the assessment tools, i.e., the PAID and the DDS-17 questionnaires, which could potentially affect prevalence, e.g., sample size, access to health care, care setting [39], and demographic variables, e.g., education level and family support, as well as health status, e.g., HbA1c level, and co-morbidity [24,41,42]. The findings of these studies are consistent with our finding that DRD prevalence is higher in people with type 2 diabetes treated in a secondary and tertiary care setting than in those treated in a primary care setting [39,43].…”

Assessment of diabetes related distress among subjects with type 2 diabetes in South India

“…It was noted that those who had high levels of DDS had poor glycemic control. Similar finding was also observed in other populations (Islam et al, 2013;Kuniss et al, 2017;Aljuaid et al, 2018). Diabetes related distress generally shows a closer association with glycemic control.…”

“…The present study highlighted that 22.5% of men and about 55% of women were screened positive for moderate to high DRD on a DDS-17 scale. Another study using DDS-17 total scores (Aljuaid et al, 2018) also reported that T2DM subjects were more likely to have DRD especially women when they belonged to the low income, unemployed or had any diabetes complications. Similar results were also observed in our study which indicated high levels of diabetes distress in women.…”

Comparison of persistence and adherence between DPP-4 inhibitor administration frequencies in patients with type 2 diabetes mellitus in Japan: a claims-based cohort study

“…In Japan, the prevalence of type 2 diabetes mellitus (T2DM) continues to rise, largely owing to the aging population 3 and lifestyle factors, such as sedentary behavior and obesity associated with westernization 4,5 . Left untreated, T2DM can have lifethreatening consequences, placing a substantial cost burden on healthcare systems [6][7][8][9][10] .…”