Diabetes distress and determinants of glycemic control among patients with type 2 diabetes mellitus- an analytical cross-sectional study in urban field practice area of a tertiary care centre in Nagpur
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20252485Keywords:
Diabetic distress, Glycemic control, Type 2 diabetes mellitusAbstract
Background: Diabetes mellitus (DM) is a global health concern with significant morbidity and mortality, particularly in India, where the prevalence is approximately 14.5% and projected to reach 80 million by 2030. Diabetes distress refers to the emotional burden and challenges of ongoing diabetes management and fear of complications. This study aimed to assess diabetes distress and identify factors influencing glycemic control among patients with type 2 diabetes mellitus (T2DM).
Methods: A cross-sectional study was conducted at the urban health training centre of a tertiary care hospital in Nagpur from February to June 2024. A total of 380 T2DM patients attending the outpatient department were screened using the diabetes distress screening scale (DDS). Patients identified with distress were further evaluated using the DDS-17 questionnaire to determine specific distress domains.
Results: Out of 380 screened, 240 participants were enrolled (mean age: 61.04 years). Poor glycemic control (HbA1c>7%) was significantly more common in males (66.6%, p=0.0037) and in the 40-60 age group (p=0.024). Those with <7 years diabetes duration had worse control (p=0.017). Moderate to severe distress was found in 41%, mainly regimen-related and emotional (36.36% each). Significant factors associated with poor control included monotherapy, infrequent follow-ups, sedentary lifestyle, smoking, family history, and inadequate diabetes knowledge.
Conclusions: Diabetes distress is prevalent among T2DM patients and is associated with poor glycemic control. Addressing distress and related factors is essential for better diabetes management outcomes.
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References
Diagnosis and Classification of Diabetes: Standards of Care in Diabetes. Diabetes Care. 2024;47(1):20-42.
Magliano DJ, Boyko EJ, International Diabetes Federation. IDF Diabetes Atlas, 10th edn. International Diabetes Federation; 2021.
Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017;5(8):585-96. DOI: https://doi.org/10.1016/S2213-8587(17)30174-2
Fisher L, Gonzalez JS, Polonsky WH. The confusing tale of depression and distress in patients with diabetes: a call for greater clarity and precision. Diabetes Med. 2014;31(7):764-72. DOI: https://doi.org/10.1111/dme.12428
American Diabetes Association. Psychosocial care for people with diabetes: a position statement. Diabetes Care. 2016;39(12):2126-40. DOI: https://doi.org/10.2337/dc16-2053
Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, et al. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005;28(3):626-31. DOI: https://doi.org/10.2337/diacare.28.3.626
Gonzalez JS, Tanenbaum ML, Commissariat PV. Psychosocial factors in medication adherence and diabetes self-management: implications for research and practice. Am Psychol. 2016;71(7):539-51. DOI: https://doi.org/10.1037/a0040388
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405-12. DOI: https://doi.org/10.1136/bmj.321.7258.405
American Diabetes Association. Glycemic targets: Standards of Medical Care in Diabetes- 2024. Diabetes Care. 2024;47(Suppl 1):83-102.
Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, et al. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 2010;362(9):800-11. DOI: https://doi.org/10.1056/NEJMoa0908359
Shrivastava SR, Shrivastava PS, Ramasamy J. Role of self-care in management of diabetes mellitus. J Diabetes Metab Disord. 2013;12(1):14. DOI: https://doi.org/10.1186/2251-6581-12-14
Ramachandran A, Snehalatha C. Current scenario of diabetes in India. J Diabetes. 2009;1(1):18-28. DOI: https://doi.org/10.1111/j.1753-0407.2008.00004.x
Kalra S, Jena BN, Yeravdekar R. Emotional and psychological needs of people with diabetes. Indian J Endocrinol Metab. 2018;22(5):696-704. DOI: https://doi.org/10.4103/ijem.IJEM_579_17
Islam MR, Karim MR, Habib SH, Yesmin K. Diabetes distress among type 2 diabetic patients. Int J Med Biomed Res. 2013;2(2):113-24. DOI: https://doi.org/10.14194/ijmbr.224
Jayaprasad N, Bhatkule PR, Narlawar UW. Association of depression, stress, and anxiety with type 2 diabetes mellitus: a case-control study. Int J Med Sci Public Health. 2018;7(4):282-7. DOI: https://doi.org/10.5455/ijmsph.2018.0103127012018
Ufuoma C, Godwin YD, Kester AD, Ngozi JC. Determinants of glycemic control among persons with type 2 diabetes mellitus in Niger Delta. Sahel Med J. 2016;19:190-5. DOI: https://doi.org/10.4103/1118-8561.196361
Fiseha T, Alemayehu E, Kassahun W, Adamu A, Gebreweld A. Factors associated with glycemic control among diabetic adult out-patients in Northeast Ethiopia. BMC Res Notes. 2018;11(1). DOI: https://doi.org/10.1186/s13104-018-3423-5
National Family Health Survey (NFHS-5), 2019-21. Available from: https://dhsprogram.com/pubs/ pdf/FR375/FR375.pdf. Accessed on 14 May 2024.
Saghir SAM, Alhariri AEA, Alkubat SA, Almiamn AA, Aladaileh SH, Alyousefi NA. Factors associated with poor glycemic control among type-2 diabetes mellitus patients in Yemen. Trop J Pharm Res. 2019;18(7):1539-46. DOI: https://doi.org/10.4314/tjpr.v18i7.26
Nagabhushana A, Ramaiah M, Khan MA, Nijaguna S. A study to assess diabetic distress and other factors which affect glycemic control in patients with type 2 diabetes mellitus. APIK J Int Med. 2021;9:176-9. DOI: https://doi.org/10.4103/ajim.ajim_8_21