Does diabetes‐related distress explain the presence of depressive symptoms and/or poor self‐care in individuals with Type 1 diabetes?

Abstract

Aims To examine the relationship between depressive symptomatology, diabetes-related distress and aspects of diabetes self-care in a cohort of individuals with Type 1 diabetes. Methods Individuals with Type 1 diabetes taking part in the Pittsburgh Epidemiology of Diabetes Complications Study completed the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies Depression (CES-D) Scale and the Problem Areas in Diabetes (PAID) scale. Self-care was measured by physical activity in the past week and over the previous year, frequency of blood glucose/urine testing, smoking status and alcohol intake. Results Clinically significant levels of depressive symptomatology (i.e. scores ≥ 16) were reported by 14% of the study population on the BDI and by 18% on the CES-D. There were strong correlations between depressive symptoms and diabetes-related distress (PAID scores) and physical activity. Multivariate analyses indicated that depression was independently associated with diabetes-related distress scores and with physical activity, but not with frequency of blood glucose testing. Conclusions These findings have implications for clinical practice and treatment of both psychological morbidity and diabetes. There may be significant effects of depression on aspects of diabetes self-care. Further prospective studies are required to confirm these findings.

Diabetes distress may adversely affect the eating styles of women with type 1 diabetes

“…Diabetes distress was positively related to A1C. This finding is congruent with previous studies [12] and highlights the serious psychological burden of managing this complex chronic disease and the effect that burden may have on behaviors. However, FOH was not significantly related to diabetes distress, eating styles, or A1C.…”

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

“…Other studies suggest DD is not associated with self-monitoring of blood glucose, smoking and alcohol consumption, and that its association with physical activity may be explained by more general emotional distress (13).This evidence base is very much underdeveloped at present, though. 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).…”

Diabetes Burden and Diabetes Distress: the Buffering Effect of Social Support

“…For example, studies have demonstrated close relationships between diabetic peripheral neuropathy severity, neuropathy symptoms, and functional impairment on the one hand and symptoms of depression on the other, both cross-sectionally and longitudinally [27, 28]. Moreover, diabetes complications have been cross-sectionally associated with increased diabetes distress [25, 29, 30] and predict the onset of significant diabetes distress over time, with the occurrence of negative life events amplifying the strength of this relationship [25]. Type 2 diabetes patients prescribed insulin, who often have greater diabetes severity and more demanding self-management requirements, also report increased diabetes distress as compared to patients on oral medications only or those not prescribed medication [13, 31].…”