Alwani Anam Anil, Kaur Ravneet, Bairwa Mohan, Misra Puneet, Nongkynrih Baridalyne
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India.
Clin Diabetes Endocrinol. 2024 Dec 9;10(1):40. doi: 10.1186/s40842-024-00203-7.
Diabetes distress "refers to the negative emotional or affective experiences resulting from the challenge of living with the demands of diabetes." Despite recommendations to screen for distress at regular intervals, it usually remains undiagnosed. This study aimed to determine the prevalence of diabetes distress among adults living with diabetes, determine the factors associated with distress, the association between selfcare and distress, glycemic control and distress and compare the health-related quality of life among those with and without distress.
This cross-sectional, community-based study was conducted in an urban colony in Delhi, India. The participants were selected using simple random sampling and included adults diagnosed with diabetes mellitus. The sample size calculated was 390. The questionnaire included the Diabetes Distress Scale 17, Diabetes Self-Management Questionnaire and Healthy Days measure. Factors associated with distress were tested using bivariate followed by multivariable logistic regression. Multivariable logistic regression was used to find the association between selfcare and distress and glycemic control and distress. Mean number of unhealthy days and health rating were compared between distressed and non-distressed diabetics using Wilcoxon rank sum test and chi square test respectively.
A total of 412 adults were included in the study, of which 35.4% had clinically significant distress. Female sex, low socio-economic status, 1 or more comorbidities, diagnosis of diabetes 10 or more years prior, being on treatment and an unmet need for social support were the factors found to be associated with distress. There was a positive association between physicians contact and distress. Those with poor glycemic control had higher odds of distress. There was a significant difference in the health reported by those with and without distress (p < 0.001). Those with distress also suffered from significantly more physically unhealthy days and mentally unhealthy days than those without distress (p < 0.001).
In this study, more than one in three diabetics were found to be distressed. Healthcare providers should increase their focus on the psychological aspects of diabetes and improve their communication with patients. Diabetes distress needs to be screened for in routine clinical settings and addressed appropriately.
糖尿病困扰“指的是因应对糖尿病生活要求所带来的负面情绪或情感体验”。尽管有定期筛查困扰情况的建议，但通常仍未被诊断出来。本研究旨在确定糖尿病成年患者中糖尿病困扰的患病率，确定与困扰相关的因素、自我护理与困扰之间的关联、血糖控制与困扰之间的关联，并比较有困扰和无困扰患者的健康相关生活质量。
这项基于社区的横断面研究在印度德里的一个城市聚居区进行。参与者通过简单随机抽样选取，包括被诊断患有糖尿病的成年人。计算得出的样本量为390。问卷包括糖尿病困扰量表17、糖尿病自我管理问卷和健康天数测量。使用双变量分析，随后进行多变量逻辑回归来测试与困扰相关的因素。多变量逻辑回归用于找出自我护理与困扰以及血糖控制与困扰之间的关联。使用威尔科克森秩和检验和卡方检验分别比较有困扰和无困扰糖尿病患者的不健康天数平均数和健康评分。
本研究共纳入412名成年人，其中35.4%有临床上显著的困扰。女性、社会经济地位低、有1种或更多合并症、糖尿病诊断时间在10年或更久之前、正在接受治疗以及对社会支持的需求未得到满足是被发现与困扰相关的因素。与医生的接触与困扰之间存在正相关。血糖控制差的人困扰的几率更高。有困扰和无困扰的人报告的健康状况存在显著差异（p < 0.001）。有困扰者身体不健康天数和精神不健康天数也显著多于无困扰者（p < 0.001）。
在本研究中，超过三分之一的糖尿病患者被发现有困扰。医疗服务提供者应更加关注糖尿病的心理方面，并改善与患者的沟通。需要在常规临床环境中筛查糖尿病困扰并进行适当处理。
