Prevalence and predictors of diabetes distress among adults with type 2 diabetes mellitus: a facility-based cross-sectional study of Bangladesh

Abstract

Introduction Diabetes distress (DD) is common and has considerable impacts on diabetes management. Unfortunately, DD is less discussed and frequently underestimated. This study evaluated the prevalence and predictors of DD in adults with type 2 diabetes mellitus (T2DM). Methods A cross-sectional study was conducted at several specialized endocrinology outpatient clinics in Bangladesh from July 2019 to June 2020; 259 adults with T2DM participated. Participants’ DD and depression were measured using the 17-item Diabetes Distress Scale (DDS-17) and 9-item Patient Health Questionnaire (PHQ-9), respectively. DDS-17 scores ≥2 and PHQ-9 scores ≥10 were the cutoffs for DD and significant depression, respectively. Results The mean (±SD) age of the participants was 50.36 (±12.7) years, with the majority (54.8%) being male; their median (IQR) duration of diabetes was 6 (3–11) years. Among the study participants, 52.5% had DD (29.7% moderate and 22.8% high DD). The prevalence of emotional burden, physician-related distress, regimen-related distress, and interpersonal distress was 68.7, 28.6, 66, and 37.7%, respectively. Depression was present in 40.5%; 28.6% of the participants had DD and depression. The total DDS-17 score was positively correlated with the PHQ-9 score (r = 0.325, p < 0.001). Rural residence (OR 1.94), presence of any diabetic complication (OR 3.125), insulin use (OR 2.687), and presence of major depression (OR 4.753) were positive predictors of DD. In contrast, age ≥ 40 years at diabetes diagnosis (OR 0.047) and diabetes duration of > 10 years (OR 0.240) were negative predictors of DD (p < 0.05 in all instances). Conclusions The prevalence of DD in our setting is notably high; DD and depression frequently overlap. Screening for diabetes distress may be considered, especially in high-risk patients.

Prevalence and Associated Factors of Diabetes Distress, Depression and Anxiety Among Primary Care Patients With Type 2 Diabetes During the COVID-19 Pandemic in Egypt: A Cross-Sectional Study

“…In the current study, diabetes duration, complications and treatment regimen were all associated with increased risks for comorbid DD, depression, and anxiety symptoms, which is consistent with previous studies (53,55,58). However, it is difficult to interpret potential risk factors for mental health disorders in T2DM as these factors often coexist and interact with each other.…”

“…Complex interactions between DM and social as well as cultural dynamics are likely to affect the way patients experience illness and health (50). Our study did not find an association between gender and higher risk for developing DD which is consistent with Kamrul-Hasan et al findings (53). However, bivariant analysis showed that females had higher risk for developing depression and anxiety although that was not confirmed with subsequent multivariant analysis.…”

“…The current study's bivariant analysis showed that illiteracy, insufficient family income, unemployment, and being divorced or widowed were associated with higher prevalence of DD, depression, and anxiety symptoms. Study findings from other countries also showed similar association although not all associations were statistically significant (53,58). Consequently, optimizing management of patients with DM does not only require a multidisciplinary team of healthcare workers, but it also involves synergistic multi-dimensional care plan of the surrounding environment.…”

Temporal trends in patients with peripheral artery disease influenced by diabetes mellitus in Germany

“…In contrast to the aforementioned decreasing amputation rates, a study on national population data from Singapore revealed increasing diabetes‐associated annual amputation rates within the observation period from 2008 to 2017 44 . The vast global and ethnic differences concerning risk for DM related to lower extremity complications and amputations were recently shown by different studies 45,46 . Data from Germany revealed controversial results regarding outcome and amputation of diabetic PAD patients.…”

“… 44 The vast global and ethnic differences concerning risk for DM related to lower extremity complications and amputations were recently shown by different studies. 45 , 46 Data from Germany revealed controversial results regarding outcome and amputation of diabetic PAD patients. German nationwide data comprising the years 2005, 2007 and 2009 demonstrated declining rates of major and inclining minor amputations in PAD patients.…”