Prevalence of diabetes distress and its relationship with self-management in patients with type 2 diabetes mellitus

CONTEXT: Diabetes distress (DD) in India has been studied mainly in the context of depression. Little is known about DD, its determinants, distribution, and its impact. AIMS: This study aims to estimate the prevalence of DD and identify its socio-demographic and clinical determinants in type 2 diabetes mellitus patients. To assess the relationship of DD with self-management in nondepressed type 2 diabetes mellitus. SETTINGS AND DESIGN: A cross-sectional descriptive study in noncommunicable disease clinic of a tertiary care medical center. SUBJECTS AND METHODS: DD Scale was used to assess DD in 200 patients with type 2 diabetes mellitus. Diabetes Self-Management Questionnaire was used to evaluate self-management behavior. Patient Health Questionnaire 9 was used to exclude depression. STATISTICAL ANALYSIS USED: Sample size calculation was done as per prevailing prevalence estimates. SPSS 20.0 was used for statistical analysis. ANOVA and Independent t-tests were done to compare between groups means. Hierarchical multiple regression analysis was done, keeping self-management as a dependent variable and socio-demographic, clinical variables, and DD as independent variables. RESULTS: The prevalence of DD was 42% in our sample. The duration of diabetes showed that a significant association with DD. DD was significantly and negatively associated with all four domains of self-management, while statistical significance was reached in three domains: dietary control (β = −0.378, P < 0.01); glucose management (β = −0.181, P < 0.01); and healthcare use (β = −0.244, P < 0.01). CONCLUSIONS: DD is widespread in our patients and harms self-management. There is a need to address DD to improve disease-specific outcomes.