Complexity of antidiabetic medication regimen is associated with increased diabetes-related distress in persons with type 2 diabetes mellitus

Abstract

IntroductionDiabetes-related distress is present in a high proportion of people with type 2 diabetes mellitus. We hypothesized that complexity of the antidiabetic medication regimen is a factor that is associated with diabetes-related distress.Research design and methodsThis was a retrospective study including a group of 74 patients managed at a tertiary care center. Patients with type 1 diabetes mellitus, steroid-induced diabetes, post-transplant diabetes, and other types of diabetes were excluded. Patients were screened using the Diabetes Distress Scale-2 (DDS-2). A Diabetes Medication Complexity Scoring (DMCS) system was developed to objectively assess the diabetes medication complexity. Based on DMCS, participants were categorized into three groups: low (n=26), moderate (n=22), and high (n=26) medication complexity.ResultsComplexity groups were similar in sociodemographic characteristics, diabetes duration, body mass index, and blood pressure as well as the prevalence of hypertension, hyperlipidemia and hypoglycemic episodes. However, there were significant differences for HbA1c with higher HbA1c in the high and moderate complexity groups than in the low group (p=0.006). The microvascular complications were also more common in higher complexity groups (p=0.003). The prevalence of diabetes-related distress (DDS-2 ≥6) was 34.6% in the low, 36.4% in the moderate and 69.2% in the high complexity groups (p=0.021). There were significant differences in DDS-2 score among complexity groups (p=0.009), with higher DDS-2 score in the high complexity group compared with the moderate (p=0.008) and low complexity groups (p=0.009). The difference in DDS-2 score remained significant after adjusting for HbA1c (p=0.024) but did not reach statistical significance after controlling for both HbA1c and microvascular complications (p=0.163).ConclusionsA complex antidiabetic medication regimen may be associated with high levels of diabetes-related distress.

Дистрес При Цукровому Діабеті

“…Проведене в США ретроспективне дослідження, в якому прийняли участь 74 хворих на ЦД2, показало, що поширеність дистресу в групі з низькою складністю схеми приймання лікарських препаратів була вдвічі нижчою, ніж у групі з високою складністю [41].…”

“…В окремих дослідженнях відзначена залежність його формування від віку хворих. В одному дослідженні він був виявлений лише у 8,9% хворих із середнім віком 60,95 року [41]. В іншому дослідженні діабетичний дистрес зафіксовано в більшості молодих хворих на ЦД2 [32].…”

“…Необхідність застосування інсулінотерапії збільшувала ризик розвитку дистресу [39]. Теж саме відзначалося при складних схемах приймання препаратів [41]. Наявність супутніх захворювань сприяла формуванню дистресу [40].…”

Effect of Rifampicin on the Pharmacokinetics of Evogliptin in Healthy Volunteers

“…8 Moreover, antidiabetic medication regimens can become more complex and stressful for the patients. 9 Enzyme induction/inhibition studies revealed that evogliptin was unlikely to induce cytochrome P450 (CYP), especially 3A, or inhibit CYP1A2, 2C9, 2C19, 2D6, or 3A4. 10 However, evogliptin exposure may be influenced by drugs that affect the pathways involved in the pharmacokinetic (PK) profile of evogliptin.…”

Psychometric Evaluation of the Diabetes Distress Scale in Patients with Type 2 Diabetes in Turkey

“…Emotional burdens and concerns related to the management of diabetes, risk of complications, unmet needs from healthcare providers, friends, and family are defined as diabetes distress [5,9]. Diabetes distress is associated with higher glycosylated hemoglobin (HbA1c) test [10] and lower diabetes-related quality of life [11]. In addition, untreated psychological disorders such as stress and distress can lead to cardiovascular problems, depression, and cognitive decline [12,13].…”