Self-Compassion, Metabolic Control and Health Status in Individuals with Type 2 Diabetes: A UK Observational Study

Abstract Aims Self-compassion is a modifiable characteristic, linked with psychological well being and intrinsic motivation to engage in positive health behaviours. We aimed to explore levels of self-compassion in individuals with type 2 diabetes (T2DM) and their association with levels of depression, diabetes-related distress and glycaemic control. Methods A cross-sectional study in 176 patients with T2DM in Leicester, UK, using three self-report questionnaires: the Self Compassion Scale (SCS); Patient Health Questionnaire (PHQ-9), and Diabetes Distress Scale (DDS-17). Demographic data, medical history and blood samples were collected. Results Majority of participants were male (n=120, 68.2%), with median [IQR] age and HbA1c of 66 [60, 71] years and 7.3 [6.7, 8.0] %, respectively. Multivariable analysis adjusting for age, gender, ethnicity and diabetes duration revealed significant association of all three scores with HbA1c: per one standard deviation increase of each score, a -0.16% reduction in HbA1c for SCS (p=0.027), 0.21% increase for PHQ-9 (p=0.012) and 0.33% increase for DDS-17 (p<0.001). Conclusions Higher levels of self-compassion and lower levels of depressive symptoms were associated with significantly better long-term diabetes control. These results reinforce the importance of emphasis on psychological parameters, including self-compassion, in the multi-disciplinary management of T2DM. We identify this as a potential area for intervention in UK practice.

Download Full-text

Self-care adherence and affective disorders in Barbadian adults with type 2 diabetes

AIMS Public Health ◽

10.3934/publichealth.2022006 ◽

2021 ◽

Vol 9 (1) ◽

pp. 62-72

Author(s):

Allison DaSantos ◽

◽

Carlisle Goddard ◽

Dalip Ragoobirsingh ◽

◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetes Management ◽

Behavioral Problem ◽

Self Care ◽

Self Report ◽

Diabetes Distress ◽

Glucose Testing ◽

Blood Glucose Testing ◽

Distress Scale

<abstract><sec> <title>Purpose</title> Diabetes management requires adherence to complicated self-care behaviors. Therefore, the emotional state of the individual living with diabetes, is likely to affect their ability to comply with recommendations. This study explored the relationship of self-care adherence to diabetes distress and depression in Barbadian adults with type 2 diabetes. </sec><sec> <title>Methods</title> Adults aged 20 to 80 years, with type 2 diabetes, completed self-report questionnaires comprised of a profile section consisting of demographic and clinical characteristics; and standardized questionnaires comprising, The Diabetes Distress Scale (DDS), The Patient Health Questionnaire (PQH-9), and the Summary of Diabetes Self-care Activities Scale (SDSCA). Additionally biological measures (BP and HbA1c) were collected. </sec><sec> <title>Results</title> For the 509 participants there were no differences in adherence for males (30.8%) and females (69.2%), high diabetes distress and depression were associated with low adherence. General diet was negatively associated with BP and HbA1c; while HbA1c was positively correlated with blood glucose testing. </sec><sec> <title>Conclusion</title> Self-care non-adherence is more than a behavioral problem; it is a multidimensional phenomenon inclusive of demographic factors, condition or disease factors, psychological and social factors. </sec></abstract>

Download Full-text

A study on diabetes-related distress among type 2 diabetes mellitus patients using the diabetes distress scale in a tertiary care center in Telangana

International Journal of Diabetes in Developing Countries ◽

10.1007/s13410-021-00937-5 ◽

2021 ◽

Author(s):

K. Sumana ◽

Shehzad Ruman ◽

M. Beatrice Anne ◽

Shiva Krishna Katkam

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Care Center ◽

Tertiary Care ◽

Diabetes Distress ◽

Tertiary Care Center ◽

Distress Scale ◽

Diabetes Distress Scale

Download Full-text

A positive psychology–motivational interviewing intervention for patients with type 2 diabetes: Proof-of-concept trial

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217418791448 ◽

2018 ◽

Vol 54 (2) ◽

pp. 97-114 ◽

Cited By ~ 8

Author(s):

Christopher M Celano ◽

Taylor A Gianangelo ◽

Rachel A Millstein ◽

Wei-Jean Chung ◽

Deborah J Wexler ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Positive Psychology ◽

Health Behaviors ◽

Motivational Interviewing ◽

Well Being ◽

Self Report ◽

Proof Of Concept ◽

Medical Outcomes

Objective Eighteen million Americans with type 2 diabetes (T2D) do not follow recommended guidelines for physical activity. Motivational interviewing (MI) has had modest effects on activity and related behaviors in T2D. Positive psychological attributes (e.g., optimism) are associated with superior medical outcomes in T2D, and positive psychology (PP) interventions promote such attributes. There had been no study in T2D of a combined PP–MI intervention to promote well-being and health behavior adherence. We developed a novel, telephone-delivered, 16-week PP–MI intervention and explored its feasibility and impact in T2D patients in a single-arm, proof-of-concept trial. Method Participants completed PP-based exercises and MI-based physical activity goal-setting activities and reviewed these activities weekly with a study trainer for 16 weeks. Feasibility and acceptability were assessed via exercise completion rates and post-exercise ratings of ease/utility (0–10 scales). Impact was explored by examining changes in physical activity (via accelerometers and self-report), other health behaviors, psychological measures, and medical outcomes (e.g., hemoglobin A1c (A1C)) from baseline to 16 weeks, using paired t tests. Results Twelve participants enrolled, and 10 provided follow-up data. Seventy-eight percent of PP–MI activities were completed, and participants rated the PP–MI content and sessions as easy (mean = 8.2/10, standard deviation (SD) = 1.9) and useful (mean = 9.1/10, SD = 1.5). PP–MI was associated with improved adherence to health behaviors and overall self-care, variable effects on accelerometer-measured activity and psychological outcomes, and modest beneficial effects on body mass index and A1C. Conclusion Further testing of this intervention is warranted in a larger, controlled trial to assess its effects on important health outcomes.

Download Full-text

What is the best measure for assessing diabetes distress? A comparison of the Problem Areas in Diabetes and Diabetes Distress Scale: results from Diabetes MILES–Australia

Journal of Health Psychology ◽

10.1177/1359105316642006 ◽

2016 ◽

Vol 23 (5) ◽

pp. 667-680 ◽

Cited By ~ 19

Author(s):

Eva K Fenwick ◽

Gwyn Rees ◽

Elizabeth Holmes-Truscott ◽

Jessica L Browne ◽

Frans Pouwer ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Convergent Validity ◽

Rasch Analysis ◽

Diabetes Distress ◽

Interpersonal Distress ◽

Distress Scale ◽

Diabetes Distress Scale

This study used Rasch analysis to examine the psychometric validity of the Diabetes Distress Scale and the Problem Areas in Diabetes scale to assess diabetes distress in 3338 adults with diabetes (1609 completed the Problem Areas in Diabetes scale ( n = 675 type 1 diabetes; n = 934 type 2 diabetes) and 1705 completed the Diabetes Distress Scale ( n = 693 type 1 diabetes; n = 1012 type 2 diabetes)). While criterion and convergent validity were good, Rasch analysis revealed suboptimal precision and targeting, and item misfit. Unresolvable multidimensionality within the Diabetes Distress Scale suggests a total score should be avoided, while suboptimal precision suggests that the Physician-related and Interpersonal distress subscales should be used cautiously.

Download Full-text

Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus

Einstein (São Paulo) ◽

10.1590/s1679-45082016ao3709 ◽

2016 ◽

Vol 14 (3) ◽

pp. 346-351 ◽

Cited By ~ 6

Author(s):

Flávia Cristina Zanchetta ◽

Danilo Donizetti Trevisan ◽

Priscila Peruzzo Apolinario ◽

Juliana Bastoni da Silva ◽

Maria Helena de Melo Lima

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Insulin Therapy ◽

Marital Status ◽

Diabetes Distress ◽

Sociodemographic Variables ◽

Emotional Burden ◽

Distress Scale

ABSTRACT Objective: To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients. Methods: A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS). Results: About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The “emotional burden”, “regimen-related distress”, and “interpersonal distress” domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175). Conclusion: These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study.

Download Full-text

The Relationships Between Diabetes Self-Care, Diabetes Time Management, and Diabetes Distress in Women With Type 2 Diabetes Mellitus

The Science of Diabetes Self-Management and Care ◽

10.1177/26350106211014438 ◽

2021 ◽

pp. 263501062110144

Author(s):

Lisa Summers-Gibson

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Effect Size ◽

Time Management ◽

Self Care ◽

Diabetes Distress ◽

Natural Setting ◽

Distress Scale

Purpose The purpose of this study was to examine the relationships between and among diabetes self-care, diabetes time management, and diabetes distress in women with type 2 diabetes mellitus (T2DM). Methods A descriptive correlational design with a total of 188 participants completed 3 valid and reliable instruments to measure the main study variables, the Diabetes Self-Management Questionnaire, the Diabetes Time Management Questionnaire, and the Diabetes Distress Scale, in an uncontrolled, natural setting using mix-mode surveys (electronic and paper). Survey responses were analyzed using several descriptive, bivariate, and multivariate analyses. Results Diabetes time management was the strongest, statistically significant, unique contributor to explaining self-care. The regression model showed that diabetes time management demonstrated a large effect size and that diabetes distress demonstrated a small effect size. Conclusions The 2 predictor variables among diabetes self-care in women showed diabetes time management had a stronger effect size compared to diabetes distress. This is the first known study to measure the influence of diabetes time management on diabetes self-care and to examine the relationship between and among diabetes time management and diabetes distress. Diabetes time management, an understudied variable in individuals with T2DM, has the potential to be a contributor to improve patient outcomes.

Download Full-text

The Validity and Reliability of Japanese Version of the Diabetes Distress Scale for Adult Patients with Type 2 Diabetes

Diabetes ◽

10.2337/db18-63-lb ◽

2018 ◽

Vol 67 (Supplement 1) ◽

pp. 63-LB

Author(s):

HIROHIDE MATSUMOTO ◽

KENTARO OKAZAKI ◽

TOSHIKI OYA ◽

NORIYUKI TAKAHASHI ◽

MINA SUEMATSU

Keyword(s):

Type 2 Diabetes ◽

Japanese Version ◽

Adult Patients ◽

Diabetes Distress ◽

Validity And Reliability ◽

Distress Scale ◽

Diabetes Distress Scale

Download Full-text

The Association between Diabetes Complications, Diabetes Distress, and Depressive Symptoms in Patients with Type 2 Diabetes Mellitus

Clinical Nursing Research ◽

10.1177/1054773820951933 ◽

2020 ◽

pp. 105477382095193

Author(s):

Qian-Qian Yang ◽

Ji-Wei Sun ◽

Di Shao ◽

Hui-Hui Zhang ◽

Cai-Feng Bai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Depressive Symptoms ◽

Diabetes Complications ◽

Mediating Effect ◽

Diabetes Distress ◽

Additive Interaction ◽

Distress Scale

This study investigated the association between diabetes complications, diabetes distress, and depressive symptoms in patients with type 2 diabetes mellitus. A total of 600 patients with type 2 diabetes mellitus were included in this study. Data were collected using the Diabetes Distress Scale and the nine-item Patient Health Questionnaire. The results showed that both diabetes complications and diabetes distress were positively associated with depressive symptoms, and diabetes distress attenuated the association between diabetes complications and depressive symptoms. The Sobel test confirmed the mediating effect of diabetes distress. Patients with both diabetes complications and diabetes distress had a higher risk of depressive symptoms than those with diabetes complications or diabetes distress alone. This study indicates that the positive association between diabetes complications and depressive symptoms is persistent and mediated by diabetes distress, and the comorbidity of diabetes complications and diabetes distress has an additive interaction effect on depressive symptoms.

Download Full-text

Quality of life in patients with type 2 diabetes after switching to insulin degludec: results from a cross-sectional survey

Quality of Life Research ◽

10.1007/s11136-020-02753-6 ◽

2021 ◽

Author(s):

Chioma Uzoigwe ◽

Michael Radin ◽

Carol M. Hamersky ◽

Mitch DeKoven ◽

Cassie Holt ◽

...

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Sleep Quality ◽

Basal Insulin ◽

Well Being ◽

Insulin Degludec ◽

World Health ◽

Distress Scale

Abstract Purpose Five quality of life (QoL) domains are particularly important to patients with type 2 diabetes (T2D) using basal insulin—sense of physical well-being, sense of safety regarding hypoglycemia, sense of diabetes as burdensome, feelings of freedom and flexibility, and sleep quality. Methods An online survey assessed these QoL domains in adult patients with T2D in the USA who had switched from a previous basal insulin to insulin degludec (IDeg): modified versions of the World Health Organization (Five) Well-Being Index (WHO-5), Hypoglycemia Attitudes and Behavior Scale (HABS; confidence and anxiety subscales only), and Diabetes Distress Scale (DDS; emotional burden and regimen-related distress subscales only); three items assessing feelings of freedom and flexibility; and one item assessing sleep quality (hours of restful sleep). Patients rated each item for their previous basal insulin and currently while using IDeg. Correlations between sleep quality and the other QoL scales were also assessed. Results In total, 152 patients completed the survey and were included in the study sample. Patients reported significantly improved scores while using IDeg on all WHO-5, DDS, HABS, feelings of freedom and flexibility item scores, and total raw/mean subscale scores (P < 0.0001). Patients also reported a significantly greater number of hours of restful sleep [mean (SD) 6.6 (2.0) vs. 5.5 (1.8); P < 0.0001]. Better sleep quality statistically significantly correlated with improved QoL in all other domains assessed. Conclusions Treatment with IDeg after switching from a previous basal insulin was associated with statistically significant improvements in all QoL domains assessed.

Download Full-text