Prevalence and Impact of Stress Among Individuals with Type 2 Diabetes Attending a Tertiary Diabetes Center in South India

Abstract

Aims and Objectives: Diabetes is a chronic health condition proving to be a major health challenge globally. Being a lifestyle-related disorder, psychosocial and behavioral factors are critical for its management, among which stress plays a contributory role. Diabetes is associated with increased risk of depression, anxiety, and stress due to its debilitating nature and complications. Stress not only affects glycemic control through biological pathways but also leads to unhealthy behavior such as binge eating, smoking, and alcohol. This study attempts to fill the lacuna between clinical and psychosocial aspects of stress and thereby determines the prevalence and impact of stress among type 2 diabetes individuals in a clinic population. Materials and Methods: This is a cross-sectional, case–control study that includes individuals with type 2 diabetes mellitus (T2DM) as well as those with normal glucose tolerance. Assessment of stress was done using a validated tool, the Depression Anxiety Stress Scale-21 (stress component). Sociodemographic characteristics, anthropometry, blood pressure, and biochemical parameters were collected in all the participants. Data were analyzed using Statistical Package for Social Sciences statistical software. Results: The prevalence of stress was significantly higher in T2DM compared to normal glucose tolerance (NGT; 43% vs 13%, P < .001). Both among T2DM and NGT, stress levels were higher in younger individuals with higher education, higher income levels, and professionals. Stress scores decreased with age at diagnosis of T2DM (16.6 [≤25 years] vs 15.6 [≥26–40 years] vs 12.7 [≥41 years], P < .001). T2DM was significantly associated with stress after adjusting for confounding factors. Conclusion: Individuals with T2DM had significantly higher prevalence of stress. Regular screening of stress could lead to better glycemic control.

Distress and Coping Strategy among Indonesian Men with Type-2 Diabetes Mellitus

“…However, there have been reports of adaptive failures, such as the inability to afford healthcare costs, being associated with low levels of distress in individuals with T2DM (Patel et al, 2023). However, other studies indicate that the high prevalence of stress in T2DM sufferers without financial problems may result from a lack of utilisation of health services (Vidyulatha et al, 2022). This finding was also evident in the participants of this study.…”

Validity and reliability of the Sinhalese version of the perceived stress scale questionnaire among Sri Lankans

“…The determination of minimum sample size was assessed at 0.9 power and 0.05 alpha ( of type I error) values based on the prevalence of perceived stress in prior conducted studies (Bernard, 2011). The incidence of perceived stress among type 2 diabetes was reported between 39.3-50% (Mortensen et al, 2022;Vidyulatha et al, 2022). Hence, we have taken 40% anticipated incidence of perceived stress among T2DM population and 50% in our study group.…”

Stress control and coping in patients with type 2 diabetes: An interventional study based on the Lazarus' Transactional model

“…About 25 percent of people with type 2 diabetes are thought to experience high levels of stress, especially in those who are treated with insulin (9).Stress is one of the effective factors in the occurrence of diabetes complications and its control is very important in preventing these complications. Some studies show that there was an association between retinopathy, nephropathy, and neuropathy with stress and depression (10).…”