Type 2 Diabetes Mellitus Related Distress in Thailand

Kongprai Tunsuchart, Peerasak Lerttrakarnnon, Kriengkrai Srithanaviboonchai, Surinporn Likhitsathian, Sombat Skulphan, Kongprai Tunsuchart, Peerasak Lerttrakarnnon, Kriengkrai Srithanaviboonchai, Surinporn Likhitsathian, Sombat Skulphan

Abstract

This study aimed to investigate prevalence and factors potentially associated with diabetes-related distress (DRD) among type 2 diabetes mellitus (T2DM) patients in a primary health care center in Thailand. This cross-sectional study was conducted with a total of 370 patients with T2DM. Data were collected at primary health care centers in Hang Dong District, Chiang Mai Province, Thailand. DRD was assessed using the Diabetes Distress Scale (DDS-17). The association between sociodemographic characteristics and other factors with DRD was analyzed using the Fisher t-test, Chi-square test, and Pearson's correlation coefficient test. The association between Hemoglobin A1c (HbA1c) and DRD was analyzed using multiple linear regression analysis. The participants had a mean age of 60.95 ± 7.96, and most were female (68.1%). Of the participants with DRD, 8.9% had moderate to high levels of distress. Education level and family support were significantly associated with the overall level of DRD. Additionally, HbA1c and co-morbidity were also significantly associated with DRD, as were emotional burden and regimen distress. Multiple linear regression analysis found that increased HbA1c was positively associated with increased DRD after adjusting for age, sex, education, duration of T2DM, co-morbidity, diabetic complications, and family support. Screening with DRD may be beneficial in T2DM patients.

Keywords: diabetes-related distress (DRD); primary care; type 2 diabetes mellitus.

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Saeedi P., Petersohn I., Salpea P., Malanda B., Karuranga S., Unwin N., Colagiuri S., Guariguata L., Motala A.A., Ogurtsova K., et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes Res. Clin. Pract. 2019;157:107843. doi: 10.1016/j.diabres.2019.107843.
    1. Chan J.C., Cho N.H., Tajima N., Shaw J. Diabetes in the Western pacific region—past, present and future. Diabetes Res. Clin. Pract. 2014;103:244–255. doi: 10.1016/j.diabres.2013.11.012.
    1. Aekplakorn W., Chariyalertsak S., Kessomboon P., Assanangkornchai S., Taneepanichskul S., Putwatana P. Prevalence of diabetes and relationship with socioeconomic status in the Thai population: National Health Examination Survey, 2004–2014. J. Diabetes Res. 2018;2018:1654530. doi: 10.1155/2018/1654530.
    1. Reutrakul S., Deerochanawong C. Diabetes in Thailand: Status and policy. Curr. Diab. Rep. 2016;16:28. doi: 10.1007/s11892-016-0725-7.
    1. American Diabetes A. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37:S81–S90. doi: 10.2337/dc14-S081.
    1. Lotfy M., Adeghate J., Kalasz H., Singh J., Adeghate E. Chronic complications of diabetes mellitus: A mini review. Curr. Diabetes Rev. 2017;13:3–10. doi: 10.2174/1573399812666151016101622.
    1. Association A.D. Standards of medical care in diabetes—2015: Summary of revisions. Diabetes Care. 2015;38:S4.
    1. Luijks H., Schermer T., Bor H., van Weel C., Lagro-Janssen T., Biermans M., de Grauw W. Prevalence and incidence density rates of chronic comorbidity in type 2 diabetes patients: An exploratory cohort study. BMC Med. 2012;10:128. doi: 10.1186/1741-7015-10-128.
    1. Sanal T.S., Nair N.S., Adhikar P. Factors associated with poor control of type 2 diabetes mel l i tus: A systematic review and Meta-analysis. J. Diabetol. 2011;3:1–10.
    1. Smith K.J., Page V., Gariepy G., Beland M., Badawi G., Schmitz N. Self-rated diabetes control in a Canadian population with type 2 diabetes: Associations with health behaviours and outcomes. Diabetes Res. Clin. Pract. 2012;95:162–168. doi: 10.1016/j.diabres.2011.10.019.
    1. Khattab M., Khader Y.S., Al-Khawaldeh A., Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J. Diabetes Complicat. 2010;24:84–89. doi: 10.1016/j.jdiacomp.2008.12.008.
    1. Kellow N.J., Savige G.S., Khalil H. Predictors of poor glycaemic control during the initial five years post-diagnosis in rural adults with type 2 diabetes. Aust. J. Rural. Health. 2011;19:267–274. doi: 10.1111/j.1440-1584.2011.01222.x.
    1. Juarez D.T., Sentell T., Tokumaru S., Goo R., Davis J.W., Mau M.M. Factors associated with poor glycemic control or wide glycemic variability among diabetes patients in Hawaii, 2006–2009. Prev. Chronic. Dis. 2012;9:120065. doi: 10.5888/pcd9.120065.
    1. Al-Hayek A.A., Robert A.A., Alzaid A.A., Nusair H.M., Zbaidi N.S., Al-Eithan M.H., Sam A.E. Association between diabetes self-care, medication adherence, anxiety, depression, and glycemic control in type 2 diabetes. Saudi Med. J. 2012;33:681–683.
    1. Kendzor D.E., Chen M., Reininger B.M., Businelle M.S., Stewart D.W., Fisher-Hoch S.P., Rentfro A.R., Wetter D.W., McCormick J.B. The association of depression and anxiety with glycemic control among Mexican Americans with diabetes living near the U.S.-Mexico border. BMC Public Health. 2014;14:176. doi: 10.1186/1471-2458-14-176.
    1. Fisher L., Mullan J.T., Arean P., Glasgow R.E., Hessler D., Masharani U. Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care. 2010;33:23–28. doi: 10.2337/dc09-1238.
    1. Tsujii S., Hayashino Y., Ishii H., Diabetes Distress and Care Registry at Tenri Study Group Diabetes distress, but not depressive symptoms, is associated with glycaemic control among Japanese patients with type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 1) Diabet Med. 2012;29:1451–1455. doi: 10.1111/j.1464-5491.2012.03647.x.
    1. Fisher L., Glasgow R.E., Strycker L.A. The Relationship Between Diabetes Distress and Clinical Depression with Glycemic Control Among Patients with Type 2 Diabetes. Diabetes Care. 2010;33:1034–1036. doi: 10.2337/dc09-2175.
    1. Fisher L., Gonzalez J.S., Polonsky W.H. The confusing tale of depression and distress in patients with diabetes: A call for greater clarity and precision. Diabet Med. 2014;31:764–772. doi: 10.1111/dme.12428.
    1. Thanakwang K., Thinganjana W., Konggumnerd R. Psychometric properties of the Thai version of the Diabetes Distress Scale in diabetic seniors. Clin. Interv. Aging. 2014;9:1353. doi: 10.2147/CIA.S67200.
    1. Polonsky W.H., Anderson B.J., Lohrer P.A., Welch G., Jacobson A.M., Aponte J.E., Schwartz C.E. Assessment of diabetes-related distress. Diabetes Care. 1995;18:754–760. doi: 10.2337/diacare.18.6.754.
    1. Zhang J., Xu C.P., Wu H.X., Xue X.J., Xu Z.J., Li Y., Gao Q., Liu Q.Z. Comparative study of the influence of diabetes distress and depression on treatment adherence in Chinese patients with type 2 diabetes: A cross-sectional survey in the People’s Republic of China. Neuropsychiatr. Dis. Treat. 2013;9:1289–1294.
    1. Parsa S., Aghamohammadi M., Abazari M. Diabetes distress and its clinical determinants in patients with type II diabetes. Diabetes Metab. Syndr. 2019;13:1275–1279. doi: 10.1016/j.dsx.2019.02.007.
    1. Chew B.H., Vos R., Mohd-Sidik S., Rutten G.E. Diabetes-related distress, depression and distress-depression among adults with type 2 diabetes mellitus in Malaysia. PLoS ONE. 2016;11:e0152095. doi: 10.1371/journal.pone.0152095.
    1. Islam M.R., Karim M.R., Habib S.H., Yesmin K. Diabetes distress among type 2 diabetic patients. Int. J. Med. Biomed. Res. 2013;2:113–124. doi: 10.14194/ijmbr.224.
    1. Fisher L., Skaff M.M., Mullan J.T., Arean P., Glasgow R., Masharani U.A. longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with Type 2 diabetes. Diabet Med. 2008;25:1096–1101. doi: 10.1111/j.1464-5491.2008.02533.x.
    1. Jia W., Gao X., Pang C., Hou X., Bao Y., Liu W., Wang W., Zuo Y., Gu H., Xiang K. Prevalence and risk factors of albuminuria and chronic kidney disease in Chinese population with type 2 diabetes and impaired glucose regulation: Shanghai diabetic complications study (SHDCS) Nephrol. Dial. Transpl. 2009;24:3724–3731. doi: 10.1093/ndt/gfp349.
    1. Ting R.Z., Nan H., Yu M.W., Kong A.P., Ma R.C., Wong R.Y., Loo K., So W.Y., Chow C.C., Ko G.T., et al. Diabetes-related distress and physical and psychological health in Chinese type 2 diabetic patients. Diabetes Care. 2011;34:1094–1096. doi: 10.2337/dc10-1612.
    1. Fisher L., Mullan J.T., Skaff M.M., Glasgow R.E., Arean P., Hessler D. Predicting diabetes distress in patients with type 2 diabetes: A longitudinal study. Diabet. Med. 2009;26:622–627. doi: 10.1111/j.1464-5491.2009.02730.x.
    1. Pandit A.U., Bailey S.C., Curtis L.M., Seligman H.K., Davis T.C., Parker R.M., Schillinger D., DeWalt D., Fleming D., Mohr D.C., et al. Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes. J. Epidemiol. Community Health. 2014;68:557–564. doi: 10.1136/jech-2013-203063.
    1. Aikens J.E. Prospective associations between emotional distress and poor outcomes in type 2 diabetes. Diabetes Care. 2012;35:2472–2478. doi: 10.2337/dc12-0181.
    1. Fisher L., Hessler D.M., Polonsky W.H., Mullan J. When Is Diabetes Distress Clinically Meaningful?: Establishing cut points for the Diabetes Distress Scale. Diabetes Care. 2012;35:259–264. doi: 10.2337/dc11-1572.
    1. Stankovic Z., Jasovic-Gasic M., Lecic-Tosevski D. Psychological problems in patients with type 2 diabetes―Clinical considerations. Vojn. Pregl. 2013;70:1138–1144. doi: 10.2298/VSP1312138S.
    1. Conversano C. Psychological common factors in chronic diseases. Front. Psychol. 2019;10:2727. doi: 10.3389/fpsyg.2019.02727.
    1. Peyrot M., Rubin R.R. Behavioral and Psychosocial Interventions in Diabetes A conceptual review. Diabetes Care. 2007;30:2433–2440. doi: 10.2337/dc07-1222.
    1. Ngamjarus C., Chongsuvivatwong V., McNeil E. n4Studies: Sample size calculation for an epidemiological study on a smart device. SMJ. 2016;68:160–170.
    1. Polonsky W.H., Fisher L., Earles J., Dud R.J., Lees J., Mullan J., Jackson R.A. Assessing psychosocial distress in diabetes: Development of the diabetes distress scale. Diabetes Care. 2005;28:626–631. doi: 10.2337/diacare.28.3.626.
    1. Zhou H., Zhu J., Liu L., Li F., Fish A.F., Chen T., Lou Q. Diabetes-related distress and its associated factors among patients with type 2 diabetes mellitus in China. Psychiatry Res. 2017;252:45–50. doi: 10.1016/j.psychres.2017.02.049.
    1. Kuniss N., Rechtacek T., Kloos C., Müller U.A., Roth J., Burghardt K., Kramer G. Diabetes-related burden and distress in people with diabetes mellitus at primary care level in Germany. Acta Diabetol. 2017;54:471–478. doi: 10.1007/s00592-017-0972-3.
    1. Kuniss N., Kramer G., Müller N., Kloos C., Lehmann T., Lorkowski S., Wolf G., Müller U.A. Diabetes-related burden and distress is low in people with diabetes at outpatient tertiary care level. Exp. Clin. Endocrinol. Diabetes. 2016;124:307–312. doi: 10.1055/s-0042-103685.
    1. Aljuaid M.O., Almutairi A.M., Assiri M.A., Almalki D.M., Alswat K. Diabetes-related distress assessment among type 2 diabetes patients. J. Diabetes Res. 2018;2018:7328128. doi: 10.1155/2018/7328128.
    1. Tol A., Baghbanian A., Sharifirad G., Shojaeizadeh D., Eslami A., Alhani F., Tehrani M.M. Assessment of diabetic distress and disease related factors in patients with type 2 diabetes in Isfahan: A way to tailor an effective intervention planning in Isfahan-Iran. J. Diabetes Metab. Disord. 2012;11:20. doi: 10.1186/2251-6581-11-20.
    1. Stoop C.H., Nefs G., Pop V.J., Wijnands-van Gent C.J., Tack C.J., Geelhoed-Duijvestijn P.H., Diamant M., Snoek F.J., Pouwer F. Diabetes-specific emotional distress in people with Type 2 diabetes: A comparison between primary and secondary care. Diabet Med. 2014;31:1252–1259. doi: 10.1111/dme.12472.
    1. Gahlan D., Rajput R., Gehlawat P., Gupta R. Prevalence and determinants of diabetes distress in patients of diabetes mellitus in a tertiary care centre. Diabetes Metab. Syndr. 2018;12:333–336. doi: 10.1016/j.dsx.2017.12.024.
    1. Karlsen B., Oftedal B., Bru E. The relationship between clinical indicators, coping styles, perceived support and diabetes-related distress among adults with type 2 diabetes. J. Adv. Nurs. 2012;68:391–401. doi: 10.1111/j.1365-2648.2011.05751.x.
    1. Conti C., Carrozzino D., Patierno C., Vitacolonna E., Fulcheri M. The clinical link between type D personality and diabetes. Front. Psychiatry. 2016;7:113. doi: 10.3389/fpsyt.2016.00113.
    1. Martino G., Bellone F., Langher V., Caputo A., Catalano A., Quattropani M.C., Morabito N. Alexithymia and Psychological Distress Affect Perceived Quality of Life in Patients with Type 2 Diabetes Mellitus. MJCP. 2019;7 doi: 10.6092/2282-1619/2019.7.2328.
    1. Settineri S., Frisone F., Merlo E.M., Geraci D., Martino G. Compliance, adherence, concordance, empowerment, and self-management: Five words to manifest a relational maladjustment in diabetes. J. Multidiscip. Healthc. 2019;12:299. doi: 10.2147/JMDH.S193752.
    1. Nanayakkara N., Pease A., Ranasinha S., Wischer N., Andrikopoulos S., Speight J., de Courten B., Zoungas S. Depression and diabetes distress in adults with type 2 diabetes: Results from the Australian National Diabetes Audit (ANDA) 2016. Sci. Rep. 2018;8:1–10. doi: 10.1038/s41598-018-26138-5.
    1. Sankar P., Sasikumar P., Medayil R., Jacob R., Sasidharan S. High Prevalence of Distress among Patients with Type 2 Diabetes (T2DM)—A Hospital-Based Cross-Sectional Study from South India. Am. Diabetes Assoc. 2018 doi: 10.2337/db18-61-LB.
    1. Ramkissoon C., Vehi J. Emotions and Diabetes; Proceedings of the International Conference on Bioinformatics and Biomedical Engineering; Granada, Spain. 15–17 April 2011.

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