Effective interventions for reducing diabetes distress: systematic review and meta-analysis

Sturt, Jackie; Dennick, Kathryn; Hessler, Danielle; Hunter, Benjamin M.; Oliver, Jennifer; Fisher, Lawrence

doi:10.1179/2057332415y.0000000004

Cited by 120 publications

(149 citation statements)

References 68 publications

(47 reference statements)

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“…While this is largely justified by literature demonstrating the benefits of intensive behavioral interventions [12, 80] and stronger intervention impact on glycemic control by adapting generic behavioral intervention approaches to focus on diabetes-specific constructs [81], this combination may not match the stressors or needs of all people with diabetes [82]. For example, it is possible that individuals experiencing acute or chronic general stressors might benefit more from behavioral interventions to target their unique sources of stress than a diabetes-specific intervention.…”

Section: Discussionmentioning

confidence: 99%

Stress and A1c Among People with Diabetes Across the Lifespan

et al. 2016

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Stress is known to negatively affect health and is a potentially serious barrier to diabetes-related health outcomes. This paper synthesizes what is known about stress and glycemic control among people with type 1 and type 2 diabetes across the lifespan. Chronic stress—especially in relation to living with diabetes—was most strongly associated with A1c, particularly among subgroups that face disproportionate stress, such as minority groups or adolescents/young adults. Mechanisms of the stress-A1c association include physiological, psychological, behavioral, and environmental links. Understanding the dimensions of stress as they relate to health in diabetes can be of significant clinical importance, and interventions targeting mechanisms that either exacerbate or buffer stress have reported modest improvements in A1c.

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Section: Discussionmentioning

confidence: 99%

Stress and A1c Among People with Diabetes Across the Lifespan

et al. 2016

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“…As a result of these concerns, the Type 1 Diabetes Distress Scale (DDS-T1) was recently developed (27). The DDS and DDS-T1 are comprised of empirically established sub-scales such as the DDS emotional burden and regimen distress sub-scales (20,27) and have been employed in research studies (28). Short forms and screeners such as the DDS2 and PAID-5 are also available (3,(29)(30)(31)).…”

Section: Measurement Of Diabetes Distressmentioning

confidence: 99%

“…Martyn-Nemeth (2014) identified that there may be a level at which DD becomes immobilising resulting in fewer behaviours to avoid hypoglycaemia at very high levels of DD (6). Sturt et al (2015b) found that in type 1 and 2, people with elevated diabetes distress alongside psychological morbidity, including low mood, were unable to convert strongly desired self-care intentions into actions (10). Conversely, individuals with diabetes distress only were more successful at initiating self-care behaviours' and developing self-efficacy indicating that DD alone is easier to target (10).…”

Section: Self-management Behavioursmentioning

confidence: 99%

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The Detection and Management of Diabetes Distress in People With Type 1 Diabetes

et al. 2015

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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.

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“…Receiving prompts as cues for action and receiving feedback on their nutritional intake alongside biofeedback through blood glucose levels are recognised behaviour change techniques that can support healthy behaviours [34]. This increased level of control over their condition and perceived treatment efficacy may additionally help reduce the levels of distress experienced [35,36].…”

Section: Opportunities For Use Of Myfood24 In a Clinical Settingmentioning

confidence: 99%

Feasibility study of an Online 24-hr Dietary Assessment Tool: myfood24, in a clinical population

Gianfrancesco¹,

Darwin²,

Albar³

et al. 2018

Preprint

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myfood24 is a comprehensive self-completed online 24-hour dietary recall tool currently used for nutritional assessments in epidemiological research. However, its clinical application has been unexplored. This mixed methods prospective observational study explores the acceptability and usability of myfood24 in a clinical population, women with gestational diabetes (GDM). Women were recruited at their first diabetes antenatal clinic appointment. To assess acceptability and usability, they were asked to complete five 24-hour dietary recalls using myfood24 over two weeks and a user experience questionnaire; with a subset invited to participate in a one-to-one semistructured interview. Of the 199 participants, mean maternal age was 33 years, mean booking BMI 29.7kg/m 2 , 36% primiparous, 57% White, 33% Asian. Of these 121 (61%) completed myfood24 at least once and 73 (37%) completed the user questionnaire; 15 were interviewed. Usability of myfood24 was measured using the System Usability Scale (SUS) and found to be good (mean 70.9, 95%CI 67.1, 74.6). Interviews identified several areas for improvement, including optimising its use for mobile devices. myfood24 appears to be acceptable and have potential to support selfmanagement and behaviour change for women with GDM but requires adaptation to record blood glucose results alongside real-time tracking of diet. Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 16

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Effective interventions for reducing diabetes distress: systematic review and meta-analysis

Cited by 120 publications

References 68 publications

Stress and A1c Among People with Diabetes Across the Lifespan

Stress and A1c Among People with Diabetes Across the Lifespan

The Detection and Management of Diabetes Distress in People With Type 1 Diabetes

Feasibility study of an Online 24-hr Dietary Assessment Tool: myfood24, in a clinical population

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