When Is Diabetes Distress Clinically Meaningful?
Open Access
- 16 January 2012
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 35 (2), 259-264
- https://doi.org/10.2337/dc11-1572
Abstract
OBJECTIVE To identify the pattern of relationships between the 17-item Diabetes Distress Scale (DDS17) and diabetes variables to establish scale cut points for high distress among patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Recruited were 506 study 1 and 392 study 2 adults with type 2 diabetes from community medical groups. Multiple regression equations associated the DDS17, a 17-item scale that yields a mean-item score, with HbA1c, diabetes self-efficacy, diet, and physical activity. Associations also were undertaken for the two-item DDS (DDS2) screener. Analyses included control variables, linear, and quadratic (curvilinear) DDS terms. RESULTS Significant quadratic effects occurred between the DDS17 and each diabetes variable, with increases in distress associated with poorer outcomes: study 1 HbA1c (P < 0.02), self-efficacy (P < 0.001), diet (P < 0.001), physical activity (P < 0.04); study 2 HbA1c (P < 0.03), self-efficacy (P < 0.004), diet (P < 0.04), physical activity (P = NS). Substantive curvilinear associations with all four variables in both studies began at unexpectedly low levels of DDS17: the slope increased linearly between scores 1 and 2, was more muted between 2 and 3, and reached a maximum between 3 and 4. This suggested three patient subgroups: little or no distress, CONCLUSIONS In two samples of type 2 diabetic patients we found a consistent pattern of curvilinear relationships between the DDS and HbA1c, diabetes self-efficacy, diet, and physical activity. The shape of these relationships suggests cut points for three patient groups: little or no, moderate, and high distress.Keywords
This publication has 17 references indexed in Scilit:
- Engagement in a Diabetes Self-management Website: Usage Patterns and Generalizability of Program UseJournal of Medical Internet Research, 2011
- Depression in Diabetes: Have We Been Missing Something Important?Diabetes Care, 2011
- Diabetes Distress but Not Clinical Depression or Depressive Symptoms Is Associated With Glycemic Control in Both Cross-Sectional and Longitudinal AnalysesDiabetes Care, 2009
- Predicting diabetes distress in patients with Type 2 diabetes: a longitudinal studyDiabetic Medicine, 2009
- A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with Type 2 diabetesDiabetic Medicine, 2008
- Development of a Brief Diabetes Distress Screening InstrumentAnnals of Family Medicine, 2008
- Clinical Depression Versus Distress Among Patients With Type 2 DiabetesDiabetes Care, 2007
- Interpretation of Changes in Health-related Quality of LifeMedical Care, 2003
- The summary of diabetes self-care activities measure: results from 7 studies and a revised scale.Diabetes Care, 2000
- Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): A critical reviewJournal of Psychiatric Research, 1994