Gupta Joshita, Khandelwal Deepak, Gupta Lovely, Dutta Deep, Mittal Suresh, Khandelwal Ritesh, Chittawar Sachin
Department of Medicine, Park Hospital, Gurugram, Haryana, India.
Department of Endocrinology and Diabetes, Khandelwal Diabetes, Thyroid and Endocrinology Clinic, Dwarka, India.
Indian J Endocrinol Metab. 2025 Mar-Apr;29(2):202-208. doi: 10.4103/ijem.ijem_170_24. Epub 2025 Apr 29.
There is limited data regarding the prevalence and predictors of diabetes distress in Indians with type 2 diabetes (T2D). The study aimed to determine the occurrence and predictors of diabetes distress in adult persons with T2D.
In a cross-sectional study, persons with T2D on pharmacotherapy for at least 1 year were evaluated. They were administered three questionnaires namely- Diabetes Distress Scale-17, Patient Health Questionnaire-9, and Morisky Medication Adherence Scale-8. Clinically meaningful data regarding diabetes complications, anthropometry, and biochemical parameters were recorded.
Two hundred persons completed the study (mean age 57 ± 9.89 years, 59% males). Overall 140 (70%) of the patients had diabetes distress (mean DDS score ≥2). Clinically significant diabetes distress (CSDD) that requires a physician's attention (mean DDS score ≥3) was seen in 75 (37.50%) of the study participants. The mean HbA1c was significantly higher in participants with CSDD (10.24 ± 2.01 vs. 7.85 ± 1.14; = <0.001). Both microvascular [retinopathy (28% vs. 5.60%; ≤ 0.001), neuropathy (28% vs. 0%; ≤ 0.001), nephropathy (32% vs. 6.40%; ≤ 0.001)] and macrovascular (CAD 24% vs. 4.80%; ≤ 0.001) and (CVA 6.67% vs. 1.60%; = 0.059) complications were significantly correlated with CSDD. Medication adherence was significantly lower in patients with CSDD (p=<0.001). An increased number of insulin injections increased BMI and HbA1c, and the presence of nephropathy were independent predictors of CSDD.
Diabetes distress is a common co-morbid condition in persons with T2D. CSDD had a significant correlation with poor glycaemic control, higher BMI, presence of nephropathy, and higher number of insulin injections.
关于2型糖尿病（T2D）印度患者中糖尿病困扰的患病率及预测因素的数据有限。本研究旨在确定成年T2D患者中糖尿病困扰的发生率及预测因素。
在一项横断面研究中，对接受药物治疗至少1年的T2D患者进行评估。他们接受了三份问卷，即糖尿病困扰量表-17、患者健康问卷-9和莫斯基 Medication 依从性量表-8。记录了有关糖尿病并发症、人体测量学和生化参数的具有临床意义的数据。
200人完成了研究（平均年龄57±9.89岁，男性占59%）。总体而言，140名（70%）患者存在糖尿病困扰（平均糖尿病困扰量表评分≥2）。75名（37.50%）研究参与者出现了需要医生关注的具有临床意义的糖尿病困扰（CSDD，平均糖尿病困扰量表评分≥3）。CSDD参与者的平均糖化血红蛋白水平显著更高（10.24±2.01 vs. 7.85±1.14；P<0.001）。微血管并发症[视网膜病变（28% vs. 5.60%；P≤0.001）、神经病变（28% vs. 0%；P≤0.001）、肾病（32% vs. 6.40%；P≤0.001）]以及大血管并发症[冠心病（24% vs. 4.80%；P≤0.001）和（脑血管意外6.67% vs. 1.60%；P=0.059）]均与CSDD显著相关。CSDD患者的药物依从性显著更低（P<0.001）。胰岛素注射次数增加、体重指数和糖化血红蛋白升高以及肾病的存在是CSDD的独立预测因素。
糖尿病困扰是T2D患者常见的共病情况。CSDD与血糖控制不佳、更高的体重指数、肾病的存在以及更多的胰岛素注射次数显著相关。
