Diabetes-related distress and its association with the complications of diabetes in Iran

Pouria Khashayar; Nooshin Shirzad; Aghil Zarbini; Alireza Esteghamati; Mahboobeh Hemmatabadi; Elham Sharafi

doi:10.1007/s40200-022-01103-2

Diabetes-related distress and its association with the complications of diabetes in Iran

J Diabetes Metab Disord. 2022 Jul 27;21(2):1569-1575. doi: 10.1007/s40200-022-01103-2. eCollection 2022 Dec.

Authors

Pouria Khashayar¹, Nooshin Shirzad^{2

3}, Aghil Zarbini⁴, Alireza Esteghamati², Mahboobeh Hemmatabadi², Elham Sharafi⁵

Affiliations

¹ Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
² Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran.
³ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Psychiatry, Psychosomatic Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Purpose: Diabetes-related distress (DRD) has negative emotional effects on the patients' quality of life. This is while the condition often goes undiagnosed despite it being common among diabetic patients. This study investigated the prevalence of DRD and its association with diabetes complications among a group of Iranian type 2 diabetic patients (T₂DM).

Methods: This descriptive-analytical cross-sectional study was conducted on 186 T₂DM patients referred to a diabetes clinic in a teaching hospital from the beginning of May 2019 to the end of April 2020. Two questionnaires on disease-related information and diabetes distress screening scale (DDS) were filled out for each patient. The latter was divided into four domains, emotional burden (EB), diabetes-related interpersonal distress (ID), physician-related distress (PD), and regimen-related distress (RD). In addition to the frequency of DRD and its association with age, sex, body mass index (BMI), hypertension, hemoglobin A₁C, duration of disease, and type of medication regimen (oral, insulin, or mix) along with the history of cardiovascular disease (CVDs), retinopathy, nephropathy, and diabetic foot were assessed.

Results: DRD was reported in 47% of the patients. Being female, old age, hypertension, high hemoglobin A₁C levels, nephropathy, and retinopathy were significantly associated with DRD (P-value = < 0.001, 0.013, 0.014, 0.007, 0.001, and 0.004, respectively). The history of the diabetic foot had a significant relationship with PD and ID (P-value = 0.007 and < 0.001, respectively). Multivariate regression showed gender and the existence of complications to have a direct effect on the development of DRD.

Conclusion: DRD prevalence is relatively high and requires screening to identify and treat high-risk patients. Further studies are needed to study diabetes, its complications and their relation with DRD to help reduce such conditions and improve the patient's quality of life.

Keywords: Complications of diabetes; Diabetes; Diabetic-related distress; Type 2 diabetes.

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