High rates of elevated diabetes distress in research populations: A systematic review and meta-analysis

Kathryn Dennick, Jackie Sturt, Danielle Hessler, Edward Purssell, Benjamin Hunter, Jennifer Oliver, Lawrence Fisher
2015 International Diabetes Nursing  
Diabetes distress is a unique phenomenon with empirically established implications for diabetes end-points. Interventions targeting diabetes distress are indicated and emerging evidence suggests effectiveness, yet preliminary work quantifying and characterising the problem is required. Objectives To identify the presence, potential magnitude (i.e. rate) and determinants of elevated diabetes distress across study populations and isolate candidate populations with the greatest need. Methods
more » ... need. Methods Medline, Psychinfo and Embase were searched for studies (n ≥50) assessing diabetes distress using the Problem Areas in Diabetes scale or Diabetes Distress Scale, in adult populations with diagnosed Type 1 or 2 diabetes. Random effects meta-analysis and meta-regression estimated the average rate of elevated diabetes distress and prognostic contribution of age, gender, HbA1c and health care context. Results Of 16,627 citations identified, adequate data were available for 58 studies. On average 22% (95% CIs 19% to 26%, P<0.0001) of participants reported elevated diabetes distress. Only female gender (β=-2.6, 95% CIs -4.17 to -0.97, P=0.002) and secondary care (β=-0.66, 95% CIs -1.18 to -0.14, P=0.01) were independently prognostic of a higher rate of elevated distress, albeit younger age (β=-0.03, 95% CIs -0.05 to -0.01, P=0.003) was significant in univariate analyses. Conclusions On average a quarter of people with diabetes have a level of diabetes distress likely to impact outcomes. Secondary care practitioners should be particularly vigilant of younger women 2 with diabetes. These findings are limited by unexplained heterogeneity between studies, reliance on unrepresentative study samples and issues associated with measuring diabetes distress. Word count: 3,712 (abstract 244)
doi:10.1080/20573316.2016.1202497 fatcat:lz4wkbb4jbgnnn36dv2l6auadu