Diabetes Distress and Associations With Demographic and Clinical Variables: A Registry Study of Adults With T1 Diabetes in Norway, 2023, Hernar et al

Discussion in 'Other health news and research' started by Midnattsol, Feb 3, 2025.

  1. Midnattsol

    Midnattsol Moderator Staff Member

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    Full title: Diabetes Distress and Associations With Demographic and Clinical Variables: A Nationwide Population-Based Registry Study of 10,186 Adults With Type 1 Diabetes in Norway

    Abstract:
    OBJECTIVE
    To estimate diabetes distress prevalence and associations with demographic and clinical variables among adults with type 1 diabetes in Norway.

    RESEARCH DESIGN AND METHODS
    In this nationwide population-based registry study, the 20-item Problem Areas in Diabetes (PAID-20) questionnaire was sent to 16,255 adults with type 1 diabetes. Linear regression models examined associations of demographic and clinical variables with distress.

    RESULTS
    In total, 10,186 individuals (62.7%) completed the PAID-20, with a mean score of 25.4 (SD 18.4) and 21.7% reporting high distress. Respondents endorsed worrying about the future and complications as the most problematic item (23.0%). Female sex, younger age, non-European origin, primary education only, unemployment, smoking, continuous glucose monitoring use, more symptomatic hypoglycemia, reduced foot sensitivity, treated retinopathy, and higher HbA1c were associated with higher distress.

    CONCLUSIONS
    Diabetes distress is common among adults with type 1 diabetes and associated with clinically relevant factors, underlining that regular care should include efforts to identify and address distress.

    Full paper can be accessed for free here
     
  2. Midnattsol

    Midnattsol Moderator Staff Member

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    I thought some might find this article on distress interesting. Worrying about the future and complications I'd say is relevant for conditions other than diabetes. Like ME/CFS diabetes involves levels of self management and stigma that patients have brought the illness on themselves. Like with us, part of the proposed solution is help to deal with anxiety not better treatment that would remove the cause of the patients' concern.
     
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  3. Utsikt

    Utsikt Senior Member (Voting Rights)

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    Norway
    One way to reduce stigma is to educated the general population. I wonder what they would have found if they asked Norwegians about basic facts about DT1&2.

    PAID-20 only has one question about interactions with others, so it appears that most of the «blame» is put on the patient:
    Uncomfortable social situations related to your diabetes care (e.g. people telling you what to eat)?
    https://professional.diabetes.org/s.../ada_mental_health_toolkit_questionnaires.pdf
     
    Kalliope likes this.
  4. Midnattsol

    Midnattsol Moderator Staff Member

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    In Norway we still have educational texts explaining diabetes type 1 as "childhood diabetes" and diabetes type 2 as "old man's diabetes", contributing to children with DT2 being treated as they have DT1 and adults with DT1 being treated as they have DT2. This is probably true in other countries as well that developed these disease nicknames.

    In stigma research, diabetes patients report being blamed for their illness and that people, including healthcare, believe they are "unhealthy" (and stupid as they don't know what is healthy and not). The more visible the diabetes illness is, for example the use of insulin injections, the more stigma is reported (the pathway is believed to be "need treatment" > "more unhealthy than patients that don't need treatment"), so this typically hits DT1 patients harder than DT2 since they are the ones who need injections.

    I'm not saying DT2 patients deserve stigma, but it is very clear how the misconceptions target the "wrong" population. Shaming a DT1 patient to live healthier won't do much for the underlying diabetes, yet they are the ones that are shamed the most. And I want to add that not all DT2 patients benefit in a clinically meaningful way from healthy lifestyle adjustments either, things like viral infections and other things that is less about individual control also contribute.
     
    Kalliope and Yann04 like this.

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