title: Correlates of diabetes-related distress in type 2 diabetes: Findings from the benchmarking network for clinical and humanistic outcomes in diabetes (BENCH-D) study.
abstract: OBJECTIVE
  To evaluate correlates of high diabetes-related distress (HD) among individuals with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  The study involved a sample of patients with T2DM who filled in the Problem Areas in Diabetes questionnaire (PAID-5); a score ≥ 40 indicates HD. Additional instruments included: SF12 health survey (SF12), Well-Being Index (WHO-5), Diabetes Empowerment Scale-Short Form (DES-SF), Patient Assessment of Chronic Illness Care-Short Form (PACIC-SF), Health Care Climate-Short Form (HCC-SF), Global Satisfaction with Diabetes Treatment (GSDT), Summary of Diabetes Self-Care Activities (SDSCA-6); Barriers to Medications (BM), Perceived Social Support (PSS). Clinical data were extracted from computerized medical records. Multivariable logistic regression analyses were performed to identify correlates of HD.
  
  
  RESULTS
  Of 2374 patients (mean age 65.0±10.2 years, diabetes duration 14.0±15.3 years, 59.9% males), 1429 (60.2%) had HD. Compared to patients with a PAID-5 score<40 those with HD were more often female, living alone, had a lower level of education, higher HbA1c levels, a greater perceived impact of hyperglycemic and hypoglycemic symptoms, a greater number of diabetes-related complications, lower scores of WHO-5, DES-SF, PSS, GSDT, SF-12 PCS, SDSCA-healthy diet and physical activity subscales, higher scores of BM and SDSCA-SMBG component. Multivariable analyses confirmed the relationship between HD and symptoms of hyperglycemia, levels of empowerment, global satisfaction with treatment, perception of barriers to medication, and psychological well-being. Conclusion HD is extremely common among people with T2DM, affecting almost two-thirds of patients. High levels of distress are associated with worse clinical and psychosocial outcomes and should be considered as a key patient-centered indicator.
authors.affiliation: SSD Diabetology, Niguarda Ca' Granda Hospital, Milan, Italy. Electronic address: basiliopinta@yahoo.it.
authors.forename: Basilio
authors.initials: B
authors.lastname: Pintaudi
authors.affiliation: Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lucisano
authors.affiliation: Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Gentile
authors.affiliation: Novo Nordisk SpA, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bulotta
authors.affiliation: Novo Nordisk A/S, Bagsværd, Denmark.
authors.forename: Soren E
authors.initials: SE
authors.lastname: Skovlund
authors.affiliation: Diabetes Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto (AP), Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Vespasiani
authors.affiliation: Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rossi
authors.affiliation: Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
mesh_terms: D000368:Aged; D019985:Benchmarking / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D003927:Diet, Diabetic; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000523:psychology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D011209:Power, Psychological; D012648:Self Care; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin
keywords: Diabetes related distress; Patient-centered outcomes; Quality of care; Type 2 diabetes