Kintzoglanakis Kyriakos, Vonta Paraskevi, Copanitsanou Panagiota
Local Health Team Unit of Thebes, Thebes, Greece.
General Hospital of Piraeus "Tzaneio", Piraeus, Greece.
Chronic Stress (Thousand Oaks). 2020 Sep 25;4:2470547020961538. doi: 10.1177/2470547020961538. eCollection 2020 Jan-Dec.
Diabetes-related distress (DRD) is a common psychological issue of people living with diabetes. International guidelines advise to take DRD into consideration in diabetes care but evidence for Greece is scarce. In the present study we aimed to estimate the frequency of DRD as assessed by Diabetes Distress Scale (DDS) and to examine its connections with clinical and sociodemographic characteristics among patients with type 2 diabetes mellitus (T2D) in urban primary care (PC) in Greece.
This descriptive survey included adults with a diagnosis of T2D of at least six months under medication treatment attending a novel, public urban PC unit. Patients with other forms of diabetes, dementia, and psychosis were excluded. Patients were screened for DRD with DDS instrument and correlations were made between DRD and clinical and sociodemographic characteristics.
In 135 eligible participants the frequency of moderate to high levels of DRD (DDS ≥ 2) was 24.4% and of high levels of DRD (DDS ≥ 3) was 7.4%. Emotional burden (EB) subscale was significantly correlated with younger age, insulin use, duration of insulin use, and the number of insulin injections per day. Longer diabetes duration showed significant correlation with DDS total, EB, and regimen distress. Participants with lower income, sedentary lifestyle, micro-vascular complications, more episodes of hypoglycaemia, and higher levels of glycated haemoglobin (HbA1c) experienced significantly higher distress.
DRD screening is important in urban PC and in more susceptible patients as those on more insulin injections per day, with longer diabetes duration, higher levels of HbA1c, lower income, sedentary lifestyle, and more episodes of hypoglycaemia.
糖尿病相关困扰(DRD)是糖尿病患者常见的心理问题。国际指南建议在糖尿病护理中考虑DRD,但希腊的相关证据较少。在本研究中,我们旨在评估通过糖尿病困扰量表(DDS)评估的DRD发生率,并研究其与希腊城市基层医疗(PC)中2型糖尿病(T2D)患者临床及社会人口学特征的关系。
这项描述性调查纳入了在一家新建的城市公共PC机构接受药物治疗至少6个月且诊断为T2D的成年人。排除患有其他形式糖尿病、痴呆和精神病的患者。使用DDS工具对患者进行DRD筛查,并分析DRD与临床及社会人口学特征之间的相关性。
在135名符合条件的参与者中,中度至高度DRD(DDS≥2)的发生率为24.4%,高度DRD(DDS≥3)的发生率为7.4%。情感负担(EB)子量表与较年轻的年龄、胰岛素使用、胰岛素使用时长及每日胰岛素注射次数显著相关。糖尿病病程较长与DDS总分、EB及治疗方案困扰显著相关。收入较低、久坐不动的生活方式、微血管并发症、更多次低血糖发作以及糖化血红蛋白(HbA1c)水平较高的参与者经历的困扰明显更高。
在城市PC中,对每天注射更多胰岛素、糖尿病病程较长、HbA1c水平较高、收入较低、久坐不动的生活方式以及低血糖发作次数更多等更易受影响的患者进行DRD筛查很重要。