Diabetes Distress and Associated Factors in Patients with Diabetes Mellitus in South East Nigeria

Abstract

Background: Diabetes distress (DD) is a common worldwide problem in diabetic patients irrespective of age and type of treatment. In the DAWN 2 study (Diabetes Attitudes, Wishes, and Needs), DD was reported by 44.6% of participants. Objectives: The purpose of this study was to assess the prevalence and level of DD and its associated factors among adult diabetic patients in South East Nigeria. Methods: The present study was cross-sectional and descriptive. Patients attending the adult diabetes clinic were enrolled. The questionnaire was administered by the investigators. All patients were eligible. Their demographic and clinical data were obtained. They were screened for DD using the DD Scale (DDS)-2 and DDS-17. Data were tabulated and analyzed using SPSS version 21. Results: There were 110 subjects (38 males and 72 females), aged 36–85 years (60.5 ± 10.0). Only 9 (8.2%) had diabetes mellitus (DM) type 1, while the rest had type 2 DM. Twenty-five subjects (22.7%) were on insulin injection. Hypertension was coexistent in 72%, and they were prescribed 3–10 medications (5.9 ± 1.5) at the time of assessment. The male and female subjects were comparable. Moderate to severe DD was present in 51.9% (DDS-17). The average scores were for DDS-2, 3.1; DDS-17, 2.3; emotional burden, 2.9; physician-related distress, 1.4; regimen-related distress, 2.5, and interpersonal distress, 2.2. Distress was significantly associated with a younger age, T1DM, longer duration of diabetes, use of insulin injection, and HbA_1C level. Conclusion: DD is a common consequence of living with diabetes and impairs diabetes self-care behavior and glycemic control. Active screening for DD should be an integral part of diabetes care. Diabetes self-management education and support should be implemented at diagnosis and as needed thereafter, especially when DD is diagnosed.

Unraveling the concepts of distress, burnout, and depression in type 1 diabetes: A scoping review

“…In addition, we found that diabetes duration was higher in the studies about diabetes distress. This is in agreement with a recent study that found an association of diabetes distress with a longer diabetes duration, younger age, use of insulin and T1D [42].…”

Prevalence of Diabetes Related Distress and Associated Factors Among Type 2 Diabetes Patients Attending Hospitals, Southwest Ethiopia, 2020: A Cross-Sectional Study

“…Studies that were done in Bangladesh 39 and Malaysia 13 using the DDS-17 scale showed that almost half of patients with T2DM had DRD. Studies in Ghana 22 and Nigeria 19 reported that 44.7% and 51.9% of patients had high levels of DRD, respectively. This discrepancy between the previously reported DRD magnitude and the current prevalence might result from better family and social support implemented in our societies and patients might have under-rated their level of distress.…”

“… 17 , 18 Studies illustrated that younger age, lower level of education, longer duration of diabetes, use of insulin injection, and higher HbA1c were factors strongly associated with higher DRD in the cross-sectional analyses. 19–21 …”

“…17,18 Studies illustrated that younger age, lower level of education, longer duration of diabetes, use of insulin injection, and higher HbA1c were factors strongly associated with higher DRD in the cross-sectional analyses. [19][20][21] High levels of DRD have been found to be a significant contributor to low levels of physical activity and nonadherence to diet and prescribed medications which in turns leads to poor glycemic control. 22,23 When compared with patients with diabetes alone, patients with diabetes and co-morbid DRD have poorer glycemic control.…”

Empowering Patients for Healthy Nutrition, Physical Activity, and Self-Care Using the Diabetes Score Questionnaire

“…By itself, pharmacologic management does not ensure improvement in long-term patient-oriented outcomes such as the quality of life or all-cause mortality. Additional nonpharmacologic interventions are needed to empower individuals to improve their quality of life [2]. Yet, a majority of these individuals remain nonadherent to lifestyle guidelines [3].…”