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

Abstract

Diabetes distress (DD) represents a significant clinical burden in which levels of DD are related to both HbA1c and some self-management behaviours. DD is related to, but different from, depression.Differences in DD experienced in people with type 1 and type 2 have been observed. Commonly measured by the Problem Areas in Diabetes Scale and the Diabetes Distress Scale, rates of elevated DD in research study participants range 20-30%. Risk factors for elevated DD in type 1 are a longer duration of diabetes, severe hypoglycaemia, younger age and being female. A systematic review of intervention studies assessing DD identified eight RCTs and nine pre-post design studies. Only three studies targeted DD with the intervention. Intervention types were diabetes self-management education (DSME); psychologically informed self-management and; devices. DSME pre-post studies, namely the DAFNE programme (Dose Adjustment For Normal Eating), produced more consistent improvements in DD and HbA1c at follow up. Psychologically informed self-management were more heterogeneous but several RCTs were effective in reducing DD. Group interventions offered the greatest benefits across intervention designs.

Distress and its association with self-care in people with type 2 diabetes

“…Data on prevalence of anxiety and depression came from Mexico; however, the referent for prevalence of distress came mainly from the United States, since these data are not available for Mexican population. At the same time, prevalence of affective disorders (anxiety and depression) found in the present study is similar to the figures reported in similar studies (Fisher et al 2012;Sturt, Dennick, Due-Christensen & McCarthy, 2015;Fisher, Glasgow & Strycker, 2010). In our study, distress in diabetic patients was associated with poor adherence to medication and lack of regular physical exercise.…”

What is diabetes distress and how can we measure it? A narrative review and conceptual model

“…Around one quarter of UK adults with diabetes experience elevated, or severe, DD at any given time (Dennick et al, 2016;Sturt, Dennick, Due-Christensen, & McCarthy, 2015). Similar rates are reported elsewhere in Europe (Stoop et al, 2014), Australia (Speight et al, 2011) and the USA (Fisher, Skaff, et al, 2008).…”

Psychosocial screening and management of young people aged 18–25 years with diabetes

“…They included: The Problems Areas in Diabetes (PAID) (20 items) with scores ≥ 40 representing severe diabetes-related distress (12,13), and a score ≥ 30 representing significant diabetes-related distress; The Kessler 10 (K10; 10 items) assessing psychological distress, focusing on depression and anxiety symptoms, ow levels of distress (10)(11)(12)(13)(14)(15), moderate (16)(17)(18)(19)(20)(21), high level (22)(23)(24)(25)(26)(27)(28)(29) and very high are defined (14,15); The WHO-5 Well-being Index (5 items) assessing quality of life, with scores ≤ 13 indicative of low well-being, and scores < 8 indicative of depression (16,17) (22), (23) were compared to USA normative data (non-diabetic), and 4 items assessed financial concerns.…”