Erasmus Medical Center, Rotterdam, the Netherlands
VU University Medical Center, Amsterdam, the Netherlands.
Diabetes Care. 2018 Sep;41(9):1854-1861. doi: 10.2337/dc17-2181. Epub 2018 Jun 26.
Diabetes distress among patients from ethnic minorities is still poorly understood. We investigated the association between ethnicity and diabetes distress among ethnic minority groups of people with type 2 diabetes in the Netherlands, focusing on the possible effects of glycemic control, lifestyle factors, cardiovascular risk factors, and diabetes complications.
Cross-sectional data from the Dutch Diabetes Pearl cohort included people with type 2 diabetes from primary, secondary, and tertiary diabetes care programs. We used the 20-item Problem Areas in Diabetes Survey (PAID) scale to assess diabetes distress; a score ≥40 is considered to represent high distress. Ethnicity was estimated on the basis of country of birth. Sociodemographic and lifestyle data were self-reported; cardiovascular and metabolic data were retrieved from medical charts. Logistic regression analysis determined the association between ethnicity and diabetes distress, with Caucasians as the reference group.
Diabetes distress scores and ethnicity were available for 4,191 people with type 2 diabetes: 3,684 were Caucasian, 83 were Asian, 51 were Moroccan, 92 were African, 134 were Latin American, 46 were Turkish, and 101 were Hindustani-Surinamese. Overall, participants in minority groups had worse health outcomes than those of Caucasian descent, and diabetes distress was more prevalent (ranging from 9.6 to 31.7%, compared with 5.8% among Caucasians), even after adjusting for age, sex, education level, alcohol use, smoking, BMI, lipid profile, HbA, medication use, and the presence of diabetes complications.
Among people with type 2 diabetes in the Netherlands, ethnicity is independently associated with high diabetes distress. Further research is warranted to explain the higher prevalence of diabetes distress in minority groups and to develop effective interventions.
少数民族患者的糖尿病困扰仍知之甚少。我们调查了荷兰 2 型糖尿病少数民族群体中种族与糖尿病困扰之间的关系，重点关注血糖控制、生活方式因素、心血管风险因素和糖尿病并发症的可能影响。
荷兰糖尿病珍珠队列的横断面数据包括来自初级、二级和三级糖尿病护理项目的 2 型糖尿病患者。我们使用 20 项糖尿病问题领域量表（PAID）评估糖尿病困扰；得分≥40 表示存在较高的困扰。种族是根据出生国估计的。社会人口统计学和生活方式数据为自我报告；心血管和代谢数据从病历中检索。逻辑回归分析确定了种族与糖尿病困扰之间的关联，以白种人作为参考组。
2 型糖尿病患者的糖尿病困扰评分和种族数据可用于 4191 人：3684 人为白种人，83 人为亚洲人，51 人为摩洛哥人，92 人为非洲人，134 人为拉丁美洲人，46 人为土耳其人，101 人为印度-苏里南人。总体而言，少数民族群体的参与者比白种人有更差的健康结果，且糖尿病困扰更为普遍（范围为 9.6%至 31.7%，而白种人为 5.8%），即使在调整了年龄、性别、教育水平、饮酒、吸烟、BMI、血脂谱、HbA、药物使用和糖尿病并发症的存在后也是如此。
在荷兰的 2 型糖尿病患者中，种族与高糖尿病困扰独立相关。需要进一步研究来解释少数民族群体中糖尿病困扰较高的原因，并制定有效的干预措施。
