scholarly journals Alleviating diabetes distress and improving diabetes self-management through health coaching in a primary care setting

2021 ◽  
Vol 14 (4) ◽  
pp. e241759
Author(s):  
Charles C Chima ◽  
Brenna Swanson ◽  
Nnabuchi Anikpezie ◽  
Jason L Salemi
Keyword(s):  
Primary Care ◽  
American Woman ◽  
Health Coaching ◽  
Self Management ◽  
Diabetes Distress ◽  
Haemoglobin A1c ◽  
Point Reduction ◽  
Effective Interventions ◽  
Novel Approach ◽  
Distress Scale

Considering the rising global burden of diabetes and its complications, effective interventions for addressing barriers to diabetes self-management are needed. Diabetes distress, a psychological barrier to diabetes self-management, has become increasingly recognised in the literature, but effective and feasible ways of addressing it in routine primary care settings are not known. We present the case of a middle-aged non-Hispanic white American woman with poorly controlled diabetes (haemoglobin A1c (HbA1c): 13.9%) and elevated diabetes distress (baseline Diabetes Distress Scale Score: 2.53) who participated in a health coaching intervention. After the 5-month programme, which included eight 45 minute long sessions with a trained health coach, the patient achieved and sustained a 0.8-point reduction in diabetes distress, an improvement in insulin adherence and a 3.6-point reduction in HbA1c. This case demonstrates a novel approach to managing diabetes distress that entails providing patients a safe, nonjudgemental space to express their feelings and explore challenges with diabetes self-management.

scholarly journals Feasibility study of real-time online text-based CBT to support self-management for people with type 1 diabetes: the Diabetes On-line Therapy (DOT) Study

2021 ◽  
Vol 9 (1) ◽  
pp. e001934
Author(s):  
Anne M Doherty ◽  
Anne Herrmann-Werner ◽  
Arann Rowe ◽  
Jennie Brown ◽  
Scott Weich ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Real Time ◽  
Instant Messaging ◽  
Controlled Trial ◽  
Self Management ◽  
Diabetes Distress ◽  
The Mean ◽  
Distress Scale

IntroductionThis study examines the feasibility of conducting diabetes-focused cognitive–behavioral therapy (CBT) via a secure online real-time instant messaging system intervention to support self-management and improve glycemic control in people with type 1 diabetes.Research design and methodsWe used a pre–post uncontrolled intervention design over 12 months. We recruited adults with type 1 diabetes and suboptimal glycemic control (HbA1c ≥69 mmol/mol (DCCT 8.5%) for 12 months) across four hospitals in London. The intervention comprised 10 sessions of diabetes-focused CBT delivered by diabetes specialist nurses. The primary outcomes were number of eligible patients, rates of recruitment and follow-up, number of sessions completed and SD of the main outcome measure, change in HbA1c over 12 months. We measured the feasibility of collecting secondary outcomes, that is, depression measured using Patient Health Questionnaire-9 (PHQ-9), anxiety measured Generalised Anxiety Disorder (GAD) and the Diabetes Distress Scale (DDS).ResultsWe screened 3177 patients, of whom 638 were potentially eligible, from whom 71 (11.1%) were recruited. The mean age was 28.1 (13.1) years, and the mean HbA1c was 84.6 mmol/mol (17.8), DCCT 9.9%. Forty-six (65%) patients had at least 1 session and 29 (41%) completed all sessions. There was a significant reduction in HbA1c over 12 months (mean difference −6.2 (2.3) mmol/mol, DCCT 0.6%, p=0.038). The change scores in PHQ-9, GAD and DDS also improved.ConclusionsIt would be feasible to conduct a full-scale text-based synchronized real-time diabetes-focused CBT as an efficacy randomized controlled trial.

scholarly journals Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bustanul Arifin ◽  
Antoinette D. I. van Asselt ◽  
Didik Setiawan ◽  
Jarir Atthobari ◽  
Maarten J. Postma ◽  
...  
Keyword(s):  
Primary Care ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Diabetes Distress ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Increased Risk ◽  
Clinical Conditions ◽  
Distress Scale ◽  
Bahasa Indonesia

Abstract Background The number of people living with diabetes mellitus (DM) in Indonesia has continued to increase over the last 6 years. Four previous studies in U.S have found that higher DD scores were associated with worse psychological outcomes, lower health-related quality of life (HRQoL) and increased risk of T2DM complications. In this study, we aimed to firstly compare DD scores in Indonesian T2DM outpatients treated in primary care versus those in tertiary care. Subsequently, we investigated whether socio-demographic characteristics and clinical conditions explain potential differences in DD score across healthcare settings. Methods A cross-sectional study was conducted on Java island in three primary care (n = 108) and four tertiary care (n = 524) facilities. The participants completed the Bahasa Indonesia version of the Diabetes Distress Scale questionnaire (DDS17 Bahasa Indonesia). Ordinal regression analysis was conducted with the quartile of the summation of the DD score as the dependent variable to investigate how the association between the level of healthcare facilities and DD altered when adding different variables in the model. Results The final adjusted model showed that the level of healthcare facilities was strongly associated with DD (p < .001), with participants in primary care having a 3.68 times (95% CI 2.46–5.55) higher likelihood of being more distressed than the participants in tertiary care. This association was detected after including the socio-demographic characteristics and clinical conditions as model confounders. Conclusions This is the first study in Indonesia to compare DD scores within different healthcare facilities. We recommend a regular DD assessment, possibly closely aligned with health-literacy partner programs, especially for T2DM patients in primary care settings.

51-LB: The Impact of Digital Health Coaching on the Diabetes Distress Scale (DDS)

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 51-LB
Author(s):  
MATTHEW ALLISON ◽  
UMA SRIVASTAVA ◽  
STEPHEN BILLY BURTON ◽  
MAZI RASULNIA ◽  
DHIREN PATEL
Keyword(s):  
Digital Health ◽  
Health Coaching ◽  
Diabetes Distress ◽  
Distress Scale ◽  
The Impact ◽  
Diabetes Distress Scale

Veterans’ Interpretation of Diabetes Distress in Diabetes Self-Management: Findings From Cognitive Interviews

2021 ◽  
pp. 263501062110434
Author(s):  
Allison A. Lewinski ◽  
Abigail Shapiro ◽  
Hayden B. Bosworth ◽  
Matthew J. Crowley ◽  
Felicia McCant ◽  
...  
Keyword(s):  
Glycosylated Hemoglobin ◽  
Personal Characteristics ◽  
Self Management ◽  
Diabetes Distress ◽  
Cognitive Interviews ◽  
Sources Of Information ◽  
Management Interventions ◽  
Study Team ◽  
Physical Limitations ◽  
Distress Scale

Purpose The purpose of this project was to identify additional facets of diabetes distress (DD) in veterans that may be present due to the veteran’s military-related experience. Methods The study team completed cognitive interviews with veterans with type 2 diabetes mellitus (T2DM) to examine how they answered the Diabetes Distress Scale (DD Scale), a tool that assesses DD. The DD Scale was used because of its strong associations with self-management challenges, physician-related distress, and clinical outcomes. Results The veterans sample (n= 15) was 73% male, mean age of 61 (SD = 8.6), 53% Black, 53% with glycosylated hemoglobin level <9%, and 67% with prescribed insulin. The DD Scale is readily understood by veterans and interpreted. Thematic analysis indicated additional domains affecting DD and T2DM self-management, including access to care, comorbidities, disruptions in routine, fluctuations in emotions and behaviors, interactions with providers, lifelong nature of diabetes, mental health concerns, military as culture, personal characteristics, physical limitations, physical pain, sources of information and support, spirituality, and stigma. Conclusions This study describes how a veteran’s military experience may contribute to DD in the context of T2DM self-management. Findings indicate clinicians and researchers should account for additional domains when developing self-management interventions and discussing self-management behaviors with individuals with T2DM.

Effects of a Primary Care–Based Chronic Care Model on Diabetes Self-Management, Diabetes Distress, and Health Care Experience

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 659-P
Author(s):  
ADDIE L. FORTMANN ◽  
JESSICA L. PRECIADO ◽  
CHRIS WALKER ◽  
ROBIN MORRISEY ◽  
KELLY BARGER ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Self Management ◽  
Diabetes Distress ◽  
Care Model ◽  
Care Experience ◽  
Health Care Experience

scholarly journals Investigating the Association Between Diabetes Distress and Self-Management Behaviors

2018 ◽  
Vol 12 (6) ◽  
pp. 1116-1124 ◽  
Author(s):  
Aneesah Khan ◽  
Pratik Choudhary
Keyword(s):  
Glycemic Control ◽  
Glucose Monitoring ◽  
Self Management ◽  
Diabetes Distress ◽  
Self Monitoring ◽  
High Distress ◽  
Future Work ◽  
Distress Scale ◽  
The Impact ◽  
Management Behaviors

Background: Diabetes distress has been linked with suboptimal glycemic control in patients with type 1 diabetes. We evaluated the effect of diabetes distress on self-management behaviors in patients using insulin pumps. Methods: We analyzed the impact of diabetes distress on self-management behaviors using pump downloads from 129 adults treated with continuous subcutaneous insulin infusion (CSII) at a single hospital clinic. Exclusion criteria were CSII treatment <6 months, pregnancy, hemoglobinopathy, and continuous glucose monitoring/sensor use. People were categorized into three groups based on the Diabetes Distress Scale-2 (DDS-2) score: < 2.5, 2.5-3.9, > 4. Results: Participants had a mean age of 45.2 ± 19.0 years; duration of diabetes 26.6 ± 16.2 years; duration of CSII 6.0 ± 3.5 years; HbA1c 8.0 ± 1.2%; and DDS-2 score 2.7 ± 1.3. Self-monitoring blood glucose (SMBG) frequency and bolus wizard usage was similar between groups. Patients with higher distress had higher HbA1c (7.7 ± 0.9 vs. 8.0 ± 0.9 vs. 8.7 ± 1.8; P = 0.004), lower frequency of set changes (4.7 ± 1.3vs. 4.8 ± 1.9 vs. 3.8 ± 1.1; P = .025), a greater number of appointments booked (5.8 ± 4.4 vs. 8.6 ± 4.8 vs. 8.1 ± 6.9; P = .021), and a greater number of appointments missed (1.9 ± 1.3 vs. 2.5 ± 1.5 vs. 3.8 ± 4.1; P = .004). Conclusions: Although in some patients, high distress may be caused by reduced self-management, in our highly trained, pump-using patients, high distress was associated with suboptimal biomedical outcomes despite appropriate self-management behaviors. Future work should further explore the relationships between diabetes distress, self-management, and glycemic control.

scholarly journals Diabetes-Related Distress and Associated Characteristics in Patients With Type 2 Diabetes in an Urban Primary Care Setting in Greece

2020 ◽  
Vol 4 ◽  
pp. 247054702096153
Author(s):  
Kyriakos Kintzoglanakis ◽  
Paraskevi Vonta ◽  
Panagiota Copanitsanou
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Sedentary Lifestyle ◽  
Diabetes Duration ◽  
Diabetes Distress ◽  
Sociodemographic Characteristics ◽  
Lower Income ◽  
Insulin Use ◽  
Distress Scale

Background Diabetes-related distress (DRD) is a common psychological issue of people living with diabetes. International guidelines advise to take DRD into consideration in diabetes care but evidence for Greece is scarce. In the present study we aimed to estimate the frequency of DRD as assessed by Diabetes Distress Scale (DDS) and to examine its connections with clinical and sociodemographic characteristics among patients with type 2 diabetes mellitus (T2D) in urban primary care (PC) in Greece. Methods This descriptive survey included adults with a diagnosis of T2D of at least six months under medication treatment attending a novel, public urban PC unit. Patients with other forms of diabetes, dementia, and psychosis were excluded. Patients were screened for DRD with DDS instrument and correlations were made between DRD and clinical and sociodemographic characteristics. Results In 135 eligible participants the frequency of moderate to high levels of DRD (DDS ≥ 2) was 24.4% and of high levels of DRD (DDS ≥ 3) was 7.4%. Emotional burden (EB) subscale was significantly correlated with younger age, insulin use, duration of insulin use, and the number of insulin injections per day. Longer diabetes duration showed significant correlation with DDS total, EB, and regimen distress. Participants with lower income, sedentary lifestyle, micro-vascular complications, more episodes of hypoglycaemia, and higher levels of glycated haemoglobin (HbA1c) experienced significantly higher distress. Conclusion DRD screening is important in urban PC and in more susceptible patients as those on more insulin injections per day, with longer diabetes duration, higher levels of HbA1c, lower income, sedentary lifestyle, and more episodes of hypoglycaemia.

Evaluating the Implementation of the Diabetes Self-Management Program in a Rural Population

2022 ◽  
Author(s):  
Kristin Pullyblank ◽  
Melissa Scribani ◽  
Lynae Wyckoff ◽  
Nicole Krupa ◽  
Jennifer Flynn ◽  
...  
Keyword(s):  
Rural Areas ◽  
Medical Records ◽  
Patient Activation ◽  
Management Program ◽  
Self Management ◽  
Diabetes Distress ◽  
Comprehensive Treatment ◽  
Post Intervention ◽  
Patient Reported ◽  
Distress Scale

The evidence-based Diabetes Self-Management Program (DSMP) has been shown to improve a variety of health-related outcomes, but the program has been challenging to implement in rural areas, and rural dissemination has been low. The purpose of this project was to evaluate the effect of implementing the DSMP on self-reported outcomes in a rural region. Through a collaboration with multiple partners, the Living Well program delivered 28 DSMP workshops from 2017 to 2019. Data were collected to determine whether there were post-intervention changes in patient-reported outcomes on measures of diabetes distress, self-management, and patient activation. In addition, secondary analysis of A1C was abstracted from the medical records of participants with type 2 diabetes who completed at least four sessions of a DSMP workshop between 2017 and 2019 and whose medical records had a A1C value in the year before the program and at least one A1C value &gt;3 months after the program. Statistically significant improvements were seen for the Diabetes Distress Scale (P = 0.0017), the Diabetes Self-Management Questionnaire (P &lt;0.0001) and the 10-item Patient Activation Measure (P &lt;0.0001). There was no evidence of change in A1C over time in analyses of all participants (P = 0.5875), but a consistent though nonsignificant (P = 0.1087) decline in A1C was seen for a subset of participants with a baseline A1C ≥8%. This evaluation provides preliminary support for implementing the DSMP as part of a comprehensive treatment and self-management plan for people living with diabetes in rural areas.

scholarly journals PILOT STUDI: MANAJEMEN DIRI PASIEN DIABETES MELITUS DI RUMAH SAKIT HL. MANAMBAI ABDULKADIR

2019 ◽  
Vol 5 (2) ◽  
pp. 107-113
Author(s):  
Satriya Pranata
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Self Efficacy ◽  
Public Awareness ◽  
Self Management ◽  
Diabetes Distress ◽  
P Value ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
Distress Scale

Background: The population of people with diabetes mellitus is increasing every year, furthermore included into number three of deadliest disease in Indonesia. The total number of patients with diabetes mellitus currently are 10.3 million, predicted in 2045, the population will increase to 16.7 million. The main cause population of people with diabetes mellitus are increasing due to public awareness regarding self-management is still less. No researcher has been conducted research about diabetes self-management in HL. Manambai Abdulkadir hospitals. Objectives of the Pilot Study: the main objective in this pilot study was to understand the self-management of people with diabetes mellitus in HL Manambai Abdulkadir hospitals. Methodology: The participants in this pilot study were people diabetes mellitus type 2 in HL Manambai Abdulkadir hospitals using cross sectional design by diabetes self-management, self-efficacy, diabetes self-management knowledge and diabetes distress scale questionnaire. Results: 60% of patients in HL Manambai Abdulkadir hospitals had lack of self-management. The result from measuring of distress scale, knowledge and self-efficacy of patients are related to self-management of patients with diabetes mellitus with P Value <0.05. Conclusion: further research is needed with additional interventions to overcome the lack of self-management to people who suffer diabetes mellitus in HL Manambai Abdulkadir Hospital.

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