Low Empowerment and Diabetes Regimen Distress Are Related to HbA1c in Low Income Type 1 Diabetes Patients in a Brazilian Tertiary Public Hospital

Overview

Journal Diabetol Metab Syndr

Publisher Biomed Central

Specialty Endocrinology

Date 2019 Jan 26

PMID 30679959

Citations 4

Authors

M S V M Silveira

A Moura Neto

A C Sposito

L Siminerio

E J Pavin

Affiliations

Soon will be listed here.

Abstract

Background: Adults with type 1 diabetes (T1D) have a high risk of developing depressive symptoms and diabetes-related distress (DD). Low socioeconomic level is associated with increased risk of poor self-management, treatment difficulties and psychological distress. The goals of this study were to document the frequency of major depressive disorder (MDD), high depressive symptoms and high DD, to assess levels of empowerment and to determine the association with each of these measures and glycemic control in a low-income Brazilian sample of adults with T1D.

Methods: In a cross-sectional study, inclusion criteria were age > 18 years and diagnosis of T1D > 6 months. Exclusion criteria were cognitive impairment, history of major psychiatric disorders, severe diabetes-related complications and pregnancy. Diagnoses of MDD were made using interview-based DSM-5 criteria. Depressive symptoms were evaluated by the depression subscale of the Hospital Anxiety and Depression Scale (HAD-D). The Diabetes Distress Scale (DDS) assessed DD. Empowerment levels were evaluated by the Diabetes Empowerment Scale short form (DES-SF). Glycemic control was measured by HbA1c. The latest lipid panel results were recorded. Number of complications was obtained from medical records.

Results: Of the 63 T1D patients recruited, 36.5% were male, mean age was 31.5 (± 8.9), mean number of complications was 1 (± 1.1), and mean HbA1c was 10.0% (± 2). Frequency of MDD was 34.9% and 34.9% reported high depressive symptoms. Fifty-seven percent reported clinically meaningful DD. High diabetes regimen distress and low empowerment were associated to HbA1c ( = ; = , respectively). In multivariate analyses, lower empowerment levels were associated to higher HbA1c ( - ; ; ). MDD and depressive symptoms were not significantly correlated with HbA1c in this expected direction (p = 0.72; p = 0.97, respectively).

Conclusions: This study showed high rates of MDD, high depressive symptoms and high DD and low levels of empowerment in this low income population. Empowerment and diabetes regimen distress were linked to glycemic control. The results emphasize the need to incorporate the psychological and psychosocial side of diabetes into strategies of care and education for T1D patients.

Citing Articles

Understanding Experiences of Diabetes Distress: A Systematic Review and Thematic Synthesis.

Morales-Brown L, Perez Algorta G, Salifu Y J Diabetes Res. 2024; 2024:3946553.

PMID: 39574786 PMC: 11581805. DOI: 10.1155/2024/3946553.

Emotional burden and care of adults with type 1 diabetes during the COVID-19 pandemic in Brazilian regions.

Silveira M, Pavin E, Cardoso E, Fanti P, Abdoli S J Diabetes Complications. 2021; 35(12):108053.

PMID: 34620557 PMC: 8597042. DOI: 10.1016/j.jdiacomp.2021.108053.

High anxiety and depressive symptoms in partners of type 1 diabetes persons in a sample of the Brazilian population.

Buin E, Pavin E, Silveira M Diabetol Metab Syndr. 2020; 12:23.

PMID: 32211074 PMC: 7092427. DOI: 10.1186/s13098-020-00531-5.

Relatively young T1D adults using fixed doses of insulin have higher diabetes distress levels in a sample of patients from a Brazilian tertiary hospital.

Silveira M, Bovi T, Pavin E Diabetol Metab Syndr. 2020; 11:104.

PMID: 31890038 PMC: 6909623. DOI: 10.1186/s13098-019-0501-3.

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