High rates of elevated diabetes distress in research populations: A systematic review and meta-analysis
DOI:
https://doi.org/10.1080/20573316.2016.1202497Keywords:
Diabetes, Diabetes distress, Prevalence, Systematic review, Meta-analysis, Meta-regressionAbstract
Diabetes distress has implications for diabetes end-points, hence targeted interventions are indicated; yet, preliminary work quantifying and characterising the problem is required. We sought to identify the potential magnitude and determinants of elevated diabetes distress across study populations. Databases such as Medline, PsycINFO and Embase were searched for studies (n ≥50) administering the problem areas in Diabetes scale or Diabetes Distress scale, in adults with Type 1 or 2 diabetes. Random effects meta-analysis and meta-regression estimated the average rate of elevated diabetes distress and prognostic contribution of age, gender, HbA1c, and health-care context. Of the 16,627 citations identified, adequate data were available for 58 studies. On average, 22% of participants reported elevated diabetes distress. Only female gender and secondary care predicted a higher rate of elevated diabetes distress. A quarter of people with diabetes have a level of distress likely to impact outcomes. Secondary-care practitioners should be vigilant of women with diabetes.
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Dennick KJ, Sturt J, Speight J. What is diabetes distress and how can we measure it? A narrative review. In preparation.
Aikens JE. Prospective associations between emotional distress and poor outcomes in type 2 diabetes. Diabetes Care. 2012;35(12):2472–78. doi: 10.2337/dc12-0181
Fisher L, Glasgow RE, Strycker LA. The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes. Diabetes Care. 2010;33(5):1034–36. doi: 10.2337/dc09-2175
Fisher L, Mullan JT, Arean P, Glasgow RE, Hessler D, Masharani U. Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses. Diabetes Care. 2010;33(1):23–28. doi: 10.2337/dc09-1238
Hessler D, Fisher L, Glasgow RE, Strycker LA, Dickinson LM, Arean PA, et al. Reductions in regimen distress are associated with improved management and glycemic control over time. Diabetes Care. 2014;37(3):617–24. doi: 10.2337/dc13-0762
Strandberg RB, Graue M, Wentzel-Larsen T, Peyrot M, Rokne B. Relationships of diabetes-specific emotional distress, depression, anxiety, and overall well-being with HbA1c in adult persons with type 1 diabetes. J Psychosom Res. 2014;77(3):174–79. doi: 10.1016/j.jpsychores.2014.06.015
Strandberg RB, Graue M, Wentzel-Larsen T, Peyrot M, Thordarson HB, Rokne B. Longitudinal relationship between diabetes-specific emotional distress and follow-up HbA1c in adults with Type 1 diabetes mellitus. Diabet Med. 2015;32:1304–10. doi: 10.1111/dme.12781
Fonda SJ, McMahon GT, Gomes HE, Hickson S, Conlin PR. Changes in diabetes distress related to participation in an internet-based diabetes care management program and glycemic control. J Diabetes Sci Technol. 2009;3(1):117–24. doi: 10.1177/193229680900300113
Zagarins SE, Allen NA, Garb JL, Welch G. Improvement in glycemic control following a diabetes education intervention is associated with change in diabetes distress but not change in depressive symptoms. J Behav Med. 2012;35(3):299–304. doi: 10.1007/s10865-011-9359-z
Weinger K, Jacobson AM. Psychosocial and quality of life correlates of glycemic control during intensive treatment of type 1 diabetes. Patient Educ Couns. 2001;42(2):123–31. doi: 10.1016/S0738-3991(00)00098-7
Fisher L, Hessler DM, Polonsky WH, Mullan J. When is diabetes distress clinically meaningful?: establishing cut points for the Diabetes Distress Scale. Diabetes Care. 2012;35(2):259–64. doi: 10.2337/dc11-1572
Joensen LE, Tapager I, Willaing I. Diabetes distress in Type 1 diabetes-a new measurement fit for purpose. Diabet Med. 2013;30(9):1132–39. doi: 10.1111/dme.12241
Sturt J, McCarthy K, Dennick K, Narasimha M, Sankar S, Kumar S. What charaterises diabetes distress and it's resolution? A documentary analysis. Int Diabetes Nurs. 2015;12(2):1–7.
Gonzalez JS, Fisher L, Polonsky WH. Depression in diabetes: have we been missing something important? Diabetes Care. 2011;34(1):236–39. doi: 10.2337/dc10-1970
Sturt JA, Whitlock S, Fox C, Hearnshaw H, Farmer AJ, Wakelin M, et al. Effects of the Diabetes Manual 1:1 structured education in primary care. Diabet Med. 2008;25(6):722–31. doi: 10.1111/j.1464-5491.2008.02451.x
Stoop C, Nefs G, Pop V, Wijnands-van Gent C, Tack CJ, Geelhoed-Duijvestijn P, et al. Diabetes-specific emotional distress in people with Type 2 diabetes: a comparison between primary and secondary care. Diabet Med. 2014;31(10):1252–59. doi: 10.1111/dme.12472
Speight J, Browne JL, Holmes-Truscott E, Hendrieckx C, Pouwer F, on behalf of the Diabetes MILES – Australia reference group (2011). Diabetes MILES – Australia 2011 Survey Report. Canberra: Diabetes Australia 2011.
Fisher L, Skaff M, Mullan J, Arean P, Glasgow R, Masharani U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with Type 2 diabetes. Diabet Med. 2008;25(9):1096–101. doi: 10.1111/j.1464-5491.2008.02533.x
Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006;23(11):1165–73. doi: 10.1111/j.1464-5491.2006.01943.x
Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care. 2001;24(6):1069–78. doi: 10.2337/diacare.24.6.1069
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12. doi: 10.1001/jama.283.15.2008
Polonsky WH, Anderson BJ, Lohrer PA, Welch G, Jacobson AM, Aponte JE, et al. Assessment of diabetes-related distress. Diabetes Care. 1995;18(6):754–60. doi: 10.2337/diacare.18.6.754
Polonsky W, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, et al. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005;28(3):626–31. doi: 10.2337/diacare.28.3.626
Welch GW, Jacobson AM, Polonsky WH. The problem areas in diabetes scale: an evaluation of its clinical utility. Diabetes Care. 1997;20(5):760–66. doi: 10.2337/diacare.20.5.760
Snoek FJ, Pouwer F, Welch GW, Polonsky WH. Diabetes-related emotional distress in Dutch and U.S. diabetic patients: cross-cultural validity of the problem areas in diabetes scale. Diabetes Care. 2000;23(9):1305–9. doi: 10.2337/diacare.23.9.1305
Schmitt A, Reimer A, Kulzer B, Haak T, Gahr A, Hermanns N. Negative association between depression and diabetes control only when accompanied by diabetes-specific distress. J Behav Med. 2015;38(3):556–64. doi: 10.1007/s10865-014-9604-3
Pouwer F, Beekman AT, Lubach C, Snoek FJ. Nurses’ recognition and registration of depression, anxiety and diabetes-specific emotional problems in outpatients with diabetes mellitus. Patient Educ Couns. 2006;60(2):235–40. doi: 10.1016/j.pec.2005.01.009
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60. doi: 10.1136/bmj.327.7414.557
Allison P. Why you probably need more imputations than you think. http://statisticalhorizons.com/more-imputations [March 2016]; 2012.
van Buuren S, Groothuis-Oudshoorn K, Robitzsch A, Vink G, Doove L, Jolani S. Mice: Multivariate imputation by chained equations (version 2.25). https://cran.r-project.org/web/packages/mice/index.html.
van Buuren S, Groothuis-Oudshoorn K. Mice: multivariate imputation by chained equations. R J Stat Softw. 2011;45(3):1–67.
Viechtbauer W. Metafor: meta-analysis package for R (version 1.9–8). https://cran.r-project.org/web/packages/metafor/index.html.
Ratitch B, Lipkovich I, O'Kelly M. Combining analysis results from multiply imputed categorical data. Chicago, USA: PharmaSUG; 2013. pp. 1–19.
Diabetes UK. Diabetes: facts and stats. London: Diabetes UK; 2015.
Whitley E, Ball J. Statistics review 3: hypothesis testing and P values. Crit Care. 2002;6(3):222–5. doi: 10.1186/cc1493
Gavard JA, Lustman PJ, Clouse RE. Prevalence of depression in adults with diabetes: an epidemiological evaluation. Diabetes Care. 1993;16(8):1167–78. doi: 10.2337/diacare.16.8.1167
Brierley S, Johnson B, Young V, Eiser C, Heller S. The importance of measuring diabetes distress in young people with Type 1 diabetes. In: Diabetes UK Professional Conference, Glasgow, United Kingdom; 2012. p. 159.
Fisher L, Mullan JT, Skaff MM, Glasgow RE, Arean P, Hessler D. Predicting diabetes distress in patients with Type 2 diabetes: a longitudinal study. Diabet Med. 2009;26(6):622–27. doi: 10.1111/j.1464-5491.2009.02730.x
Graue M, Haugstvedt A, Wentzel-Larsen T, Iversen MM, Karlsen B, Rokne B. Diabetes-related emotional distress in adults: reliability and validity of the Norwegian versions of the Problem Areas in Diabetes Scale (PAID) and the Diabetes Distress Scale (DDS). Int J Nurs Stud. 2012;49(2):174–82. doi: 10.1016/j.ijnurstu.2011.08.007
Luyckx K, Rassart J, Weets I. Illness self-concept in Type 1 diabetes: a cross-sectional view on clinical, demographic, and psychosocial correlates. Psychol Health Med. 2015;20(1):77–86. doi: 10.1080/13548506.2014.902482
Zoffmann V, Vistisen D, Due-Christensen M. A cross-sectional study of glycaemic control, complications and psychosocial functioning among 18- to 35-year-old adults with type 1 diabetes. Diabet Med. 2014;31(4):493–99. doi: 10.1111/dme.12363
Grigsby AB, Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. Prevalence of anxiety in adults with diabetes: a systematic review. J Psychosom Res. 2002;53(6):1053–60. doi: 10.1016/S0022-3999(02)00417-8
Kessler RC. Epidemiology of women and depression. J Affect Disord. 2003;74(1):5–13. doi: 10.1016/S0165-0327(02)00426-3
Gregg EW, Gu Q, Cheng YJ, Narayan KM, Cowie CC. Mortality trends in men and women with diabetes, 1971 to 2000. Ann Intern Med. 2007;147(3):149–55. doi: 10.7326/0003-4819-147-3-200708070-00167
Franzini L, Ardigo D, Cavalot F, Miccoli R, Rivellese AA, Trovati M, et al. Women show worse control of type 2 diabetes and cardiovascular disease risk factors than men: results from the MIND.IT Study Group of the Italian Society of Diabetology. Nutr Metab Cardiovasc Dis. 2013;23(3):235–41. doi: 10.1016/j.numecd.2011.12.003
Hessler D, Fisher L, Mullan J, Glasgow RE, Masharani U. Patient age: a neglected factor when considering disease management in adults with type 2 diabetes. Patient Educ Couns. 2011;85(2):154–59. doi: 10.1016/j.pec.2010.10.030
Lerman-Garber I, Barron-Uribe C, Calzada-Leon R, Mercado-Atri M, Vidal-Tamayo R, Quintana S, et al. Emotional dysfunction associated with diabetes in Mexican adolescents and young adults with type-1 diabetes. Salud Publica Mex. 2003;45(1):13–18. doi: 10.1590/S0036-36342003000100002
Delahanty LM, Grant RW, Wittenberg E, Bosch JL, Wexler DJ, Cagliero E, et al. Association of diabetes-related emotional distress with diabetes treatment in primary care patients with Type 2 diabetes. Diabet Med. 2007;24(1):48–54. doi: 10.1111/j.1464-5491.2007.02028.x
Sheils E, Knott J, Cavan D, Shaban C. Fear of hypoglycaemia: Is there an association with glycaemic control, hypoglycaemic symptoms and diabetes emotional distress in people with Type 1 diabetes? In: Diabetes UK Professional Conference, Glasgow, United Kingdom; 2012. p. 157.
Ali Z, Patel NH. Glycaemic control, emotional attitudes and quality of life in patients living with Type 1 diabetes. In: Diabetes UK Professional Conference, Manchester, United Kingdom; 2013. p. 104.
Schmitt A, Reimer A, Kulzer B, Haak T, Ehrmann D, Hermanns N. How to assess diabetes distress: comparison of the Problem Areas in Diabetes Scale (PAID) and the Diabetes Distress Scale (DDS). Diabet Med. 2015;33(6):835–843. doi:10.1111/dme.12887
Sturt J, Dennick K, Due-Christensen M, McCarthy K. The detection and management of Diabetes Distress in people with Type 1 Diabetes. Curr Diab Rep. 2015;15(11):101. doi: 10.1007/s11892-015-0660-z
Islam MR, Islam MS, Karim MR, Alam UK, Yesmin K. Predictors of diabetes distress in patients with type 2 diabetes mellitus. Int J Res Med Sci. 2014;2(2):631–38. doi: 10.5455/2320-6012.ijrms20140549
Pandit AU, Bailey SC, Curtis LM, Seligman HK, Davis TC, Parker RM, et al. Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes. J Epidemiol Commun Health. 2014;68(6):557–64. doi: 10.1136/jech-2013-203063
Lipscombe C, Burns RJ, Schmitz N. Exploring trajectories of diabetes distress in adults with type 2 diabetes; a latent class growth modeling approach. J Affect Disord. 2015;188:160–66. doi: 10.1016/j.jad.2015.08.003
The Diabetes Times Website. Ninjabetic – It's not just a questionnaire. http://diabetestimes.co.uk/ninjabetic-its-not-just-a-questionnaire/#sthash.3mK7vTFq.7vg1HrpW.dpbs [February 2016]; 2015.
Sturt J, Dennick K, Hessler D, Fisher L, Hunter B, Oliver J. Effective interventions for reducing diabetes distress: systematic review and meta-analysis. Int Diabetes Nurs. 2015;12(2):1–16.
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