title: Diabetes-Related Burden and Distress is Low in People with Diabetes at Outpatient Tertiary Care Level.
abstract: OBJECTIVE
  The importance of diabetes-related distress (DRD) for the treatment of diabetes is emphasized in national and international guidelines recommending routinely screening for psychosocial problems. To detect DRD, the PAID (Problem Area In Diabetes) questionnaire provides a valid and reliable instrument.
  
  
  METHODS
  783 patients with diabetes mellitus type 1 (DM1, n=191, age 54.5 y, diabetes duration 22.5 y, HbA1c 7.2% (55 mmol/mol)) and type 2 (DM2, n=592, age 66.6 y, diabetes duration 15.6 y, HbA1c 7.0% (60.1 mmol/mol)) were interviewed with the PAID and WHO-5 questionnaire in a University outpatient department for endocrinology and metabolic diseases in 2012. A PAID score≥40 (range 0-100) was considered as high DRD.
  
  
  RESULTS
  The mean PAID score was 17.1±15.1 in all participants. Only 8.9% of all responders showed high DRD (score≥40). The PAID score neither differed in people with DM1 and DM2, nor between participants with DM2 with or without insulin therapy. Females achieved significantly higher scores than men (19.0±16.6 vs. 15.6±13.7, p=0.003). A strong negative correlation existed between the PAID score and the WHO-5 Well-being Index (r=- 0.482, p<0.001). A 10 points higher WHO-5 Well-being Index was associated with 15.9 points lower PAID score in people with DM1 (p<0.001), and 9.2 points lower PAID score in DM2 (p<0.001), respectively. One percent higher HbA1c was associated with an increase of diabetes-related distress by 2.5 points in people with DM1 and by 2.0 points in people with DM2.
  
  
  CONCLUSIONS
  Less than 10% of our outpatients with diabetes showed high diabetes-related distress.
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Kuniss
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Kramer
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Müller
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Kloos
authors.affiliation: Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Lehmann
authors.affiliation: Institute of Nutrition, Friedrich Schiller University Jena, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Lorkowski
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Wolf
authors.affiliation: Department of Internal Medicine III, Jena University Hospital, Jena, Germany.
authors.forename: U A
authors.initials: UA
authors.lastname: Müller
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D063128:Tertiary Health Care