Eight Tips For Managing Diabetes Distress
Eight Tips For Managing Diabetes Distress Many people experience considerable distress about having diabetes and the amount of hands-on management that diabetes requires. This often includes frustration with the ongoing obligations of diet, physical activity, blood glucose monitoring , and taking medicines. Other equally important but less frequently acknowledged stresses can center around fears about the future, concerns about complications , difficulties dealing with caring but potentially intrusive friends and family members, and keeping up with all of the new drugs, treatment options, and related recommendations from the diabetes community. It is no wonder that as a group, people with diabetes report relatively high levels of personal distress, fatigue, frustration, anger, burnout, and feelings of poor mood and depression. Diabetes can feel overwhelming because of the unending demands of self-management. The distress associated with diabetes and its management can have an effect on diabetes itself. For example, several studies have shown that people with diabetes who report more depressive symptoms have poorer management of their diet, physical activity, oral diabetes drug usage, and blood glucose monitoring, report more family conflict around diabetes, have more contact with the health-care system, and have higher levels of both diabetes complications and death from any cause over time than people with diabetes who do not have elevated levels of depressive symptoms. The reasons for these associations are not completely clear, but two mechanisms have been proposed. First, research has indicated that distress and symptoms of depression are linked to the production of cortisol, a hormone produced by the adrenal glands. Among other actions, cortisol has been shown to Continue reading >>
Internet Intervention For Diabetes Distress
Diabetes distress is a psychological phenomenon associated with the self-management of the disease and is characterised by feelings of anxiety, guilt, helplessness, defeat, and depression. Research suggests that internet-delivered interventions have the potential to increase people's ability to self-manage their symptoms, but whether they are effective is largely unknown. This study is designed to investigate the potential effectiveness of an internet-delivered intervention for diabetes distress in patients with type 2 diabetes. Show Detailed Description Study Type : Interventional (Clinical Trial) Estimated Enrollment : 42 participants Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Acceptability and Clinical Feasibility of an Internet-delivered Intervention for Psychological Distress in Patients With Type 2 Diabetes Actual Study Start Date : March 15, 2017 Estimated Primary Completion Date : September 15, 2017 Estimated Study Completion Date : December 10, 2017 Arm Intervention/treatment Experimental: Space from Diabetes Participants will be assigned the 'Space from Diabetes' intervention in a supported mode for 8 weeks. Participants are assigned a clinical supporter, who will be a psychological well-being practitioner in an NHS Mental Health Service. As the participant works through the programme content, the supporter will provide them with a review of their progress and interactions with the platform 6 times over the 8 week supported period. Behavioral: Space from Diabetes Space from Diabetes is an internet-delivered cognitive behaviour therapy-based programme for symptoms of depression, anxiety, & diabetes distress in people with type 2 diabetes mellitus. Primary Outcome Measures : Diabetes Distress Continue reading >>
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Psychosocial Aspects Of Diabetes Management: Dilemma Of Diabetes Distress
Psychosocial aspects of diabetes management: dilemma of diabetes distress Psychosocial aspects of diabetes management: dilemma of diabetes distress Psychosocial aspects of diabetes management: dilemma of diabetes distress Western Michigan University Homer Stryker M.D. School of Medicine Contributions: (I) Conception and design: RS Tareen; (II) Administrative support: K Tareen; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Ruqiya Shama Tareen, MD. Department of Psychiatry, Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA. Email: Abstract: Diabetes mellitus (DM) is a debilitating chronic illness with complex pathophysiological, psychological, and quality of life (QoL) implications creating a constant state of turbulence. Some of these interconnections are apparent to healthcare providers and are easily addressed in a routine diabetic clinical care. However, a large number of these hidden factors that interplay with each other and impact on the physical outcomes of DM goes unnoticed by health care providers. This is a frustrating and lonely predicament for DM patients making it very difficult for them to manage their illness well. At times these patients are mislabeled as difficult patients. In other cases they are considered to have and unnecessarily treated for psychiatric illness like depression, other mood or anxiety spectrum disorders which they may not need. In recent years clinical researcher are making strides in understanding the emotional distress a DM patient may feel and the factors contributing or perpetuating diabete Continue reading >>
Diabetes Distress Or Major Depressive Disorder? A Practical Approach To Diagnosing And Treating Psychological Comorbidities Of Diabetes
Diabetes Distress or Major Depressive Disorder? A Practical Approach to Diagnosing and Treating Psychological Comorbidities of Diabetes 1Duke University School of Nursing, Durham, NC USA 2Duke University Medical Center, Durham, USA 1Duke University School of Nursing, Durham, NC USA 2Duke University Medical Center, Durham, USA Kathryn Evans Kreider, Email: [email protected] . The presence of major depressive disorder (MDD) in people with diabetes may be up to three times more common than in the general population. People with diabetes and major depressive disorder have worse health outcomes and higher mortality rates. Diabetes distress refers to an emotional state where people experience feelings such as stress, guilt, or denial that arise from living with diabetes and the burden of self-management. Diabetes distress has also been linked to worse health outcomes. There are multiple treatment options for MDD including pharmacotherapy and cognitive behavioral approaches. Providers treating patients with diabetes must be aware of the frequent comorbidity of diabetes, diabetes distress, and depression and manage patients using a multidisciplinary team approach. This article discusses the epidemiology, pathophysiology, and bi-directional relationship of diabetes and depression and provides a practical, patient-centered approach to diagnosis and management. Keywords: Chronic care management, Depression, Diabetes distress, Major depressive disorder Major depressive disorder (MDD) is a debilitating chronic condition that may affect every aspect of life. Studies have shown that people with diabetes and MDD are more likely to have poorer health outcomes including uncontrolled blood sugars, complications from diabetes, and higher rates of all-cause mortality [ 1 ]. In additio Continue reading >>
Dealing With Diabetes Distress
home / diabetes center / diabetes a-z list / dealing with diabetes distress article Want More News? Sign Up for MedicineNet Newsletters! THURSDAY, Feb. 16, 2017 (HealthDay News) -- People with diabetes have to think about their condition and make treatment decisions constantly -- and all that extra work and worry can lead to psychological distress at times. " Diabetes distress" isn't the same as depression , however, diabetes experts note. It's a condition unique to the 24/7 demands that come with diabetes, particularly for people dependent on insulin . "The day you develop diabetes, it's like the universe just handed you a new full-time job that you have to do in addition to whatever else you're doing. It's a special job that has a big impact on the rest of your life. There's no pay and no vacation," said William Polonsky, president of the Behavioral Diabetes Institute in San Diego. Alicia McAuliffe-Fogarty, vice president of lifestyle management at the American Diabetes Association, put it this way: "Diabetes distress is the extra burden that people with diabetes have to carry. They have to do everything that other people do -- take care of work, family, finances -- and in addition they have to make sure to check their blood sugar, remember to take their medicine and/or adjust their insulin doses, count carbohydrates when they eat. "It's a day-to-day and minute-to-minute burden. It's doing everything 'right' and still seeing your blood sugar levels go up," she added. Diabetes distress is a range of different emotional responses that come with dealing with the burdens of caring for diabetes, Polonsky explained. "It's being fed up and overwhelmed with the demands and concerns of diabetes. It's feeling powerless in the face of diabetes. It's knowing that despite your be Continue reading >>
Diabetes Distress Learning Center - Diabetes University Dmcp
Diabetes Distress leads to frustration, anger, disappointment,fatigue, disorganization, and burnout for both the clinician and the patient.This leads to a sense of failure and a feeling that nothing can be done by office staff,clinicians, and patients. Actions, words, and non verbal behavior from all three groupsindicate this in one way or another. Suspect Diabetes Distress in any patient who is notachievingtheir goals for A1C, LDL B/P or has significant difficulty with selfmanagemente.g nutrition, weight,orphysicalactivity. Start with the DDS2 a 2 question screening test--if the scores are 3 or greater then go to DDS17 a 17 question test. Dr. Fisher cautions that use of the DDS 2 may not be effective and it is of more value to use the full scale or a few sub scales. Although the test can be self administered I find it helpful for it to beadministeredby the clinician or other Health Care Provider (HCP) to the patient. The DDS 17 is available in English and Spanish. Click here to download the questionnaires and scoring sheet. If you would like to learn more about Diabetes Distress you can download slides (pdf format) that provide more information by clicking here . After reviewing the slides and you wish to obtain a Diabetes Distress Learning Center Certificate (below) you will need to take a test. The test is set up for you to make 100. Click here to take the test. Thequestionnairecan be selfadministeredbut I have found it helpful to read thequestionnairewith the patient. This provides theopportunityforthe patient toexpand on theiranswer and Health CarePractitioner (HCP)candiscover more about patient feelings. When the HCP administersthequestionnaire this createstrust andstrengtheningof the bond with thepatient. It also provides opportunityto start treatment. Treatment Continue reading >>
Jmu-the Impact Of A Mobile Diabetes Health Intervention On Diabetes Distress And Depression Among Adults: Secondary Analysis Of A Cluster Randomized Controlled Trial | Quinn | Jmir Mhealth And Uhealth
On Wednesday, September 5, 2018 at 7:30 am Eastern Time, JMIR will be completing a server migration to improve site stability and user experience. We expect to be back online Wednesday, September 5, 2018 at 12:00 pm Eastern Time. Should any problems arise, our technical team will be using the rest of the week to resolve them, and users will be able to access our site by Thursday, September 6, 2018 at 0:01 am Eastern Time. Readers: There will be no access to all 28 journals. We recommend to access our articles via PubMed Central Authors: No access to submission form or user account Peer-reviewers: No access to user account. Please download manuscripts you are reviewing offline prior to Tuesday, September 4 Editors: No access to user account to assign reviewers or make decisions. Copyeditors: No access to user account. Please download manuscripts you are copyediting offline prior to Tuesday, September 4 Preprints (earlier versions) of this paper are available at , first published Sep 06, 2017. This paper is in the following e-collection/theme issue: The Impact of a Mobile Diabetes Health Intervention on Diabetes Distress and Depression Among Adults: Secondary Analysis of a Cluster Randomized Controlled Trial 1Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, MD, United States 2School of Social Work, Fordham University, Baltimore, NY, United States Department of Epidemiology and Public Health Background: Diabetes is a complex, demanding disease that requires the constant attention of patients. The burden of self-management, including different medication regimens, routine self-care activities, and provider visits, has an impact on patients emotional well-being. Diabetes distress and depression are two important components Continue reading >>
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Depression, Distress, And Diabetes
When a diabetic patient is also dealing with depression, there are myriad issues to consider for both the physician and the patient. Everything from diabetes distress and medications to alcohol consumption can affect both conditions. For people with diabetes, depression acts as a magnifier. It can worsen the pain of diabetes-related neuropathy and wreak havoc on blood glucose by disturbing appetite and sapping the energy required for regular physical activity. Diverse studies such as the Diabetes and Aging Study and the Pittsburgh Epidemiology of Diabetes Complications Study suggest that people with both diabetes and depression have more than twice the risk of early mortality than people who have only diabetes. According to a May 2013 paper published in SelfCare, roughly 11% of adults with diabetes have major depression, and 31% have clinically relevant depression, harking back to a 2001 study in Diabetes Care. With statistics like that, it’s a given endocrinologists will encounter patients with diabetes who are struggling with depression. Yet more recent evidence, such as research presented by Lawrence Fisher, PhD, professor of family and community medicine at the University of California–San Francisco at the American Diabetes Association’s 74th Scientific Sessions in June 2014, suggests that depressive symptoms in people with diabetes often point not to clinical depression, but to diabetes distress, a separate, if similar, condition. Whereas depression is overarching, diabetes distress is about the emotional burdens of managing diabetes in particular. “Over the past few years, we have found that many cases diagnosed as depression really were more specific to how fed up and discouraged people were with their diabetes. Sometimes people were misdiagnosed,” says Continue reading >>
When Is Diabetes Distress Clinically Meaningful?
When Is Diabetes Distress Clinically Meaningful? Establishing Cut Points for the Diabetes Distress Scale Lawrence Fisher, PHD, ABPP; Danielle M. Hessler, PHD; William H. Polonsky, PHD, CDE; Joseph Mullan, PHD 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, <2.0; moderate distress, 2.02.9; high distress, 3.0. Parallel findings occurred for the DDS2. 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 p Continue reading >>
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Diabetes Distress Scale And Treatment Outcome: Perspectives Of Clinical And Psychometric Outcome In Diabetic Patients
Some factors that may increase the risk of T2DM ineffective treatment and adverse drugs reaction. Distress felt during the period of therapy may also cause treatment ineffectiveness. The purpose of this study was to determine the correlations between distress caused by T2DM and bothclinical and psychometric outcomes of treatment. This study used cross-sectional design. Data collection of 80 samples from Dok II Hospital, Jayapura was done prospectively to T2DM patients who met the inclusion and exclusion criteria. Diabetes Distress Scale (DDS) and European Quality-5 Dimensions(EQ5D) were used as research instruments. All EQ5D domains gave range of mean score of 1.091.16, showing that the patients had good quality of life. There were significant correlations between DDS17 domains and EQ5D index and VAS, for instance: emotional burden-EQ5D index, physician-relateddistress-EQ5D index and treatment management distress-EQ5D index and VAS. The significant correlations were also shown between DDS17 domains and clinical treatment outcomes namely: emotional burden-GDS, physician-related distress-GDP, physician-related distress-GD2PP, and emotional burden-HbA1C.Emotional distress, treatment management, and physician-related distress experienced by the patients give impacts to their quality of life and clinical therapy outcome in terms of blood sugar levels. No Reference information available - sign in for access. No Citation information available - sign in for access. Keywords: Clinical ; DDS ; Indonesia ; Psychometirc ; T2DM Patients Affiliations:1: Magister of Pharmacy, Faculty of Pharmacy, Universitas Ahmad Dahlan, Jl Prof. Dr. Soepomo, 55164 Yogyakarta, Indonesia 2: Dok II Hospital, Jayapura, Indonesia ADVANCED SCIENCE LETTERS is an international peer-reviewed journal with a Continue reading >>
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Depression And Diabetes Distress In Adults With Type 2 Diabetes: Results From The Australian National Diabetes Audit (anda) 2016
Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA) 2016 Scientific Reportsvolume8, Articlenumber:7846 (2018) | Download Citation This study explores the prevalence of, and factors associated with, likely depression and diabetes distress in adults with type 2 diabetes in a large, national sample. Australian National Diabetes Audit data were analysed from adults with type 2 diabetes attending 50 diabetes centres. The Brief Case find for Depression and Diabetes Distress Score 17 were administered to screen for likely depression and diabetes-related distress, respectively. A total of 2,552 adults with type 2 diabetes participated: (mean SD) age was 63 13 years, diabetes duration was 12 10 years, and HbA1c was 8 2%. Twenty-nine percent of patients had likely depression, 7% had high diabetes distress, and 5% had both. Difficulty following dietary recommendations, smoking, forgetting medications, and diabetes distress were all associated with greater odds of depression whereas higher own health rating was associated with lower odds (all p < 0.02). Female gender, increasing HbA1c, insulin use, difficulty following dietary recommendations and depression were all associated with greater odds of diabetes distress & older age, higher own health rating and monitoring blood glucose levels as recommended were associated with lower odds (all p < 0.04). Depression was associated with sub-optimal self-care, while diabetes distress was associated with higher HbA1c and sub-optimal self-care. Driven by ageing, obesity and sedentary lifestyles, type 2 diabetes mellitus (T2DM) currently affects just under 400 million individuals worldwide and is expected to rise exponentially, affecting 592 million by 2035 1 . Globally, Continue reading >>
The Influence Of Diabetes Distress On Digital Interventions For Diabetes Management In Vulnerable People With Type 2 Diabetes: A Qualitative Study Of Patient Perspectives - Sciencedirect
The influence of diabetes distress on digital interventions for diabetes management in vulnerable people with type 2 diabetes: A qualitative study of patient perspectives Author links open overlay panel Anne SophieMathiesena Informants had several barriers towards the use of digital interventions. Diabetes distress may lead to poor adaption of digital interventions. An appropriate buddy may pave the way to better diabetes management. Informants preferred contact with a designated caregiver rather than digital interventions. Diabetes distress was a central issue requiring attention in this group of patients. Digital interventions for improving diabetes management in Type 2 diabetes mellitus (T2DM) are used universally. Digital interventions are defined as any intervention accessed and taking input from people with T2DM in the form of a web-based or mobile phone-based app to improve diabetes self-management. However, the current confidence in digital interventions threatens to augment social inequalities in health, also known as the digital divide. To counteract dissemination of the digital divide, we aimed to assess the potential of a tailored digital intervention for improving diabetes management in vulnerable people with T2DM. A qualitative design using semi-structured in-depth interviews to explore the perspectives of 12 vulnerable people with T2DM. Interviews were analyzed using inductive content analysis. Vulnerability was defined by the presence of one or more comorbidities, one or more lifestyle risk factors, poor diabetes management, low educational level and low health literacy. The main themes identified were: Dealing with diabetes distress characterized by psychological avoidance mechanisms; Suffering informational confusion dealing with inconsistent informat Continue reading >>
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Do You Have Diabetes Distress?
Everyday Solutions are created by Everyday Health on behalf of our partners. More Information Content in this special section was created or selected by the Everyday Health editorial team and is funded by an advertising sponsor. The content is subject to Everyday Healths editorial standards for accuracy, objectivity, and balance. The sponsor does not edit or influence the content but may suggest the general topic area. Feeling overwhelmed can make living with diabetes more difficult. Learn how to spot the signs of diabetes distress and how to get in control of your diabetes management. If living with diabetes is leaving you feeling anxious, overwhelmed, or burned out, you could be experiencing diabetes distress, also called diabetes-related distress. And although you might not get an official diagnosis for it, diabetes distress can still make diabetes management more difficult. However, there are effective strategies to help you overcome it. How you feel about your diabetes can be directly connected to how well you manage the condition. In fact, according to a study in the November 2012 issue of the journal Diabetes Medicine, people who have type 2 diabetes and diabetes distress have a harder time managing their blood sugar over time. The researchers found a link between diabetes distress and higher A1C results, the test that measures how well you're controlling your blood sugar over a three-month period. Despite these findings, your doctor may have a hard time bringing up the topic of diabetes distress, and you might feel awkward about letting your doctor know that you're burning out, feeling anxious, or getting overwhelmed. But this is a discussion that should happen regularly as a part of good diabetes care, says Lawrence Fisher, PhD, a diabetes researcher, diabetes Continue reading >>
Depression And Distress In Diabetes
Introduction Diabetes, like any chronic disease, is associated with an increased risk for depression and distress. In fact, people with diabetes have a twofold higher prevalence of depression compared with the general population.1,2 Researchers speculate that shared biological and behavioral mechanisms (eg, hypothalamic-pituitary-adrenal axis activation, inflammation, autonomic dysfunction, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors) may underlie this relationship.1 Depression and diabetes distress have been linked to worsening outcomes, including poor glycemic control and self-management as well as increased health care costs and mortality.3-5 Thus, early recognition and treatment of depression and diabetes distress are essential to achieving optimal goals in the management of depression and in patients’ overall quality of life. It is important to differentiate between true depression and diabetes distress as these conditions require different management approaches. Overview: Depression and Diabetes Distress While “depression” is typically used as a catch-all term for mood symptoms in patients with diabetes, it is important to differentiate between depression and diabetes distress. Depression Depression is a condition in which patients meet at least five of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) criterion for major depressive disorder (MDD) nearly every day during the same 2-week period.6 These criterion include:6 Depressed mood most of the day Reduced interest or pleasure in all or almost all activities Marked weight loss or weight gain Sleep disorders Psychomotor agitation or retardation Fatigue or loss of energy Feelings of worthlessness or guilt (excessive or Continue reading >>
Examining Diabetes Distress, Medication Adherence, Diabetes Self-care Activities, Diabetes-specific Quality Of Life And Health-related Quality Of Life Among Type 2 Diabetes Mellitus Patients
Examining diabetes distress, medication adherence, diabetes self-care activities, diabetes-specific quality of life and health-related quality of life among type 2 diabetes mellitus patients Author links open overlay panel ZeinabJannooa A five-factor theoretical model is proposed. The SEM model evaluated relationships among three endogenous and two exogenous variables. Higher levels of medication adherence had a significant direct effect on diabetes distress. Self-care activities had significant direct effect on diabetes distress and HRQoL. Diabetes-specific QoL had a significant effect on HRQoL. Health-Related Quality of Life (HRQoL) has been increasing attention in health outcome studies. Factors that individually influence HRQoL, diabetes self-care behaviors, and medication adherence have been widely investigated; however, most previous studies have not tested an integrated association between multiple health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking HRQoL, diabetes distress, diabetes self-care activities, medication adherence and diabetes-dependent QoL in patients with Type 2 Diabetes Mellitus (T2DM). A cross-sectional study design was employed, and 497 patients with T2DM were recruited from outpatient clinics in three public hospitals and one government clinic. The patients completed a series of questionnaires. The hypothetical model was tested using Structural Equation Modeling (SEM) analysis. The values of the multiple fit indices indicated that the proposed model provided a good fit to the data. SEM results showed that medication adherence (MMAS) had a significant direct effect on diabetes distress (PAID) (Beta=0.20). The self-care activities (SDSCA) construct was significantly related to PAID (Beta=0. Continue reading >>
