medwireNews: Research indicates that despite a lot of overlap, diabetes distress can arise from different experiences according to whether people have type 1 or type 2 diabetes.
This suggests “a need to tailor treatment for people with each type of diabetes,” say Elizabeth Beverly (Ohio University, Athens, USA) and study co-authors.
The researchers conducted semi-structured interviews with 48 people aged an average of 45.8 years. Nineteen had type 1 diabetes and 29 had type 2 diabetes, with average durations of 17.4 and 10.8 years, respectively.
The team identified three major themes relating to diabetes distress, namely, lack of control, management burden, and the value of social support.
Lack of control was tied to glucose levels, but also to other people’s misconceptions. Participants reported issues with others being judgmental about the food they ate, irrespective of whether they had type 1 or type 2 diabetes.
People with type 2 diabetes had to deal with other people’s assumptions that they had brought their health problems on themselves, whereas people with type 1 diabetes frequently found low awareness of their condition among other people, who assumed they had type 2 diabetes and judged them accordingly.
“Additionally, people with Type 1 diabetes admitted to having prejudicial feelings towards people with Type 2 diabetes and viewing them in very negative and blaming ways,” write the researchers in Diabetic Medicine.
Another aspect of lack of control related to people’s emotional reactions to diabetes. Here, people with type 1 diabetes spoke mostly about how their emotions changed in response to hypo- and hyperglycemic episodes, whereas those with type 2 diabetes talked of their frustrations linked to the change in lifestyle necessitated by their diagnosis.
Both groups of participants had distress related to the constant management burden, but whereas those with type 2 diabetes discussed the overwhelming feeling of a lifetime diagnosis, people with type 1 diabetes were more focused on the life-threatening consequences of lapsing in their self-care.
“Importantly, these perceptions of danger are a reality for people with Type 1 diabetes,” stress Beverly and team.
Finally, the participants highlighted the value of social support, and those with type 1 diabetes spoke positively about the impact of support from healthcare professionals, family and friends, and peers with diabetes.
“In contrast, our Type 2 participants expressed a desire for, but an absence of, this support,” say the researchers.
“This finding may be understood through the lens of judgment and blame associated with Type 2 diabetes.”
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