German Jashalynn, Kobe Elizabeth A, Lewinski Allison A, Jeffreys Amy S, Coffman Cynthia, Edelman David, Batch Bryan C, Crowley Matthew J
Department of Medicine, Division of Endocrinology, Diabetes, & Metabolism, Duke University, Durham, NC 27710, USA.
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
J Endocr Soc. 2023 Feb 28;7(5):bvad031. doi: 10.1210/jendso/bvad031. eCollection 2023 Mar 6.
Examine factors associated with increased diabetes distress (DD) among patients with type 2 diabetes with DD assessed by Diabetes Distress Scale (DDS) total and subscale scores (emotional burden, physician-related distress, regimen-related distress, and interpersonal distress).
Cross-sectional analysis of data from veterans with persistently poorly controlled diabetes mellitus. Multivariable linear regression models included baseline patient characteristics (independent variables) and DDS total and subscale scores (dependent variable).
The cohort's (N = 248) mean age was 58 years (SD 8.3); 21% were female, 79% were non-White, and 5% were Hispanic/Latinx. Mean hemoglobin A1c (HbA1c) was 9.8%, and 37.5% had moderate to high DD. Hispanic/Latinx ethnicity (β=0.41; 95% CI 0.01, 0.80), baseline HbA1c (0.07; 95% CI 0.01,0.13), and higher Personal Health Questionnaire-8 (PHQ-8) scores (0.07; 95% CI 0.05, 0.09) were associated with higher total DD. Hispanic/Latinx ethnicity (0.79; 95% CI 0.25, 1.34) and higher PHQ-8 (0.05; 95% CI 0.03, 0.08) were associated with higher interpersonal-related distress. Higher HbA1c (0.15; 95% CI 0.06, 0.23) and higher PHQ-8 scores (0.10; 95% CI 0.07, 0.13) were associated with higher regimen-related distress. The use of basal insulin (0.28; 95% CI 0.001, 0.56) and higher PHQ-8 (0.02; 95% CI 0.001, 0.05) were associated with higher physician-related distress. Higher PHQ-8 (0.10; 95% CI 0.07, 0.12) was associated with higher emotional burden.
Hispanic/Latinx ethnicity, depressive symptoms, uncontrolled hyperglycemia, and insulin use were associated with higher risk for DD. Future research should explore these relationships, and interventions designed to reduce diabetes distress should consider accounting for these factors.
通过糖尿病困扰量表（DDS）总分及各子量表得分（情绪负担、与医生相关的困扰、与治疗方案相关的困扰和人际困扰），研究2型糖尿病伴糖尿病困扰患者中与糖尿病困扰增加相关的因素。
对糖尿病控制一直不佳的退伍军人的数据进行横断面分析。多变量线性回归模型纳入基线患者特征（自变量）和DDS总分及各子量表得分（因变量）。
该队列（N = 248）的平均年龄为58岁（标准差8.3）；21%为女性，79%为非白人，5%为西班牙裔/拉丁裔。平均糖化血红蛋白（HbA1c）为9.8%，37.5%有中度至高度糖尿病困扰。西班牙裔/拉丁裔种族（β=0.41；95%可信区间0.01，0.80）、基线HbA1c（0.07；95%可信区间0.01，0.13）和较高的个人健康问卷-8（PHQ-8）得分（0.07；95%可信区间0.05，0.09）与更高的糖尿病困扰总分相关。西班牙裔/拉丁裔种族（0.79；95%可信区间0.25，1.34）和较高的PHQ-8得分（0.05；95%可信区间0.03，0.08）与更高程度的人际相关困扰相关。更高的HbA1c（0.15；95%可信区间0.06，0.23）和更高的PHQ-8得分（0.10；95%可信区间0.07，0.13）与更高程度的治疗方案相关困扰相关。基础胰岛素的使用（0.28；95%可信区间0.001，0.56）和更高的PHQ-8得分（0.02；95%可信区间0.001，0.05）与更高程度的与医生相关的困扰相关。更高的PHQ-8得分（0.10；95%可信区间0.07，0.12）与更高的情绪负担相关。
西班牙裔/拉丁裔种族、抑郁症状、血糖控制不佳和胰岛素使用与糖尿病困扰风险较高相关。未来的研究应探索这些关系，旨在减轻糖尿病困扰的干预措施应考虑这些因素。
