title: Factors associated with psychological distress, behavioral impact and health-related quality of life among patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  Data on psychological distress (DIS), behavioral impact (BI) and health-related quality of life (HRQoL) are important yet lacking among Asian patients with Type 2 diabetes mellitus (T2DM). We aim to identify factors associated with DIS, BI and HRQoL among T2DM to better understand patient needs.
  
  
  METHODS
  DIS was measured with Diabetes Health Profile (DHP-18) Psychological Distress (DHP-PD) subscale, Problem Areas in Diabetes (PAID) and Kessler-10 (K10), BI with DHP-18 Barriers to Activity and Disinhibited Eating subscales and HRQoL with Audit of Diabetes-Dependent Quality of Life. Multiple linear regression analyses were performed to evaluate the associations between these outcomes and patient demographic, socioeconomic status, glycated hemoglobin (HbA1C) and comorbidities.
  
  
  RESULTS
  213 T2DM patients (mean (SD) age: 45.0 (12.1) years, mean (SD) HbA1C: 8.3% (1.9%) and 70.0% reported at least one comorbidity) were evaluated. Poorer glycemic control was significantly associated with higher DHP-PD, PAID and worse HRQoL. Taking oral hypoglycemic agents plus insulin was independently associated with Barrier to Activity and Disinhibited Eating.
  
  
  CONCLUSIONS
  Poorer glycemic control was only associated with diabetes-related distress (measured by DHP-PD and PAID) but not major depressive disorder (measured by K10). It may be more appropriate to screen for diabetes-related distress rather than major depressive disorder for patients with T2DM.
authors: Department of Medicine, National University Health System, Singapore.
authors: Michelle Ang
authors: MA
authors: Co
authors: School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Luor Shyuan Maudrene
authors: LS
authors: Tan
authors: Department of Medicine, National University Health System, Singapore; School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: E Shyong
authors: ES
authors: Tai
authors: Department of Psychology, National University of Singapore, Singapore.
authors: Konstadina
authors: K
authors: Griva
authors: Department of Psychology, National University of Singapore, Singapore.
authors: Mohamed
authors: M
authors: Amir
authors: Department of Medicine, National University Health System, Singapore.
authors: Kok Joon
authors: KJ
authors: Chong
authors: Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Yung Seng
authors: YS
authors: Lee
authors: Department of Medicine, National University Health System, Singapore.
authors: Jeannette
authors: J
authors: Lee
authors: Department of Medicine, National University Health System, Singapore.
authors: Eric Yin-Hao
authors: EY
authors: Khoo
authors: Department of Pharmacy, National University of Singapore, Singapore. Electronic address: phawhl@nus.edu.sg.
authors: Hwee-Lin
authors: HL
authors: Wee
mesh_terms: D000328:Adult; D001519:Behavior; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents
keywords: Barriers to activity; Behavioral impairment; Disinhibited eating; Health-related quality of life; Psychological distress; Type 2 diabetes mellitus