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Diabetes-related burden and distress in people with diabetes mellitus at primary care level in Germany

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Abstract

Aims

The importance of diabetes-related distress for the treatment of diabetes is emphasised in national and international guidelines recommending routinely screening for psychosocial problems. Data of investigations regarding diabetes-related distress on primary care are rare in Germany though most people with diabetes are treated without insulin therapy at primary care level.

Methods

Three hundred and forty-five people with diabetes mellitus type 2 (DM2, n = 336, 229 without and 107 with insulin therapy) and type 1 (DM1, n = 9) were interviewed with the PAID questionnaire in the period from 1 October 2015 to 31 December 2015 in a general practice. A PAID score ≥40 (range 0–100) was considered as high diabetes-related distress.

Results

The mean PAID score of all participants was 3.9 ± 7.0 (DM2 without insulin 2.7 ± 6.3, DM2 with insulin therapy 6.0 ± 8.0, DM1 6.8 ± 4.9) and far below the threshold of 40 points. Only 1.2% of all responders showed high diabetes-related distress (score ≥40). People on insulin therapy with HbA1c >7.5% and with diagnosed depression prior to the study scored significantly higher. Furthermore, there are weak correlations between the PAID score and HbA1c (r = 0.253, p < 0.001), duration of diabetes (r = 0.169, p = 0.002), insulin dosage (r = 0.283, p < 0.001) and age (r = −0.129, p = 0.016).

Conclusions

Only 1.2% of our outpatients with diabetes on primary care level showed high diabetes-related distress. Higher rates in the current literature are probably due to not investigating on primary care level. Guidelines should consider this.

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Abbreviations

BMI:

Body mass index

DM1:

Diabetes mellitus type 1

DM2:

Diabetes mellitus type 2

HbA1c:

Glycated haemoglobin

PAID:

Problem Areas in Diabetes

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Correspondence to N. Kuniss.

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All authors declare that they have no conflict of interests.

Ethical standard

The study was conducted in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.

Human and animal rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Managed by Antonio Secchi.

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Kuniss, N., Rechtacek, T., Kloos, C. et al. Diabetes-related burden and distress in people with diabetes mellitus at primary care level in Germany. Acta Diabetol 54, 471–478 (2017). https://doi.org/10.1007/s00592-017-0972-3

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  • DOI: https://doi.org/10.1007/s00592-017-0972-3

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