Diabetes-specific emotional distress in people with Type 2 diabetes

A comparison between primary and secondary care

C.H. Stoop, G.M. Nefs, V.J.M. Pop, C.J. Wijnands-van Gent, C.J. Tack, P.H. Geelhoed-Duijvestijn, M. Diamant, F.J. Snoek, F. Pouwer

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Abstract

Aims
To compare levels of diabetes distress in people with Type 2 diabetes treated in primary and secondary care and to examine demographic and clinical correlates that may explain potential differences in levels of distress between care settings.
Methods
People with Type 2 diabetes from 24 primary care practices (n = 774) and three secondary care clinics (n = 526) completed the Problem Areas In Diabetes questionnaire. Data on HbA1c levels and diabetes complications were derived from medical charts. Hierarchical ordinal regression analysis was used to investigate which correlates could explain the potential differences in level of diabetes distress between care settings.
Results
Diabetes distress levels and the prevalence of elevated diabetes distress were considerably lower in the participants treated in primary care (mean (sd) total diabetes distress score 8 (11); 4% of participants with a Problem Areas In Diabetes score ≥ 40) than in secondary care (mean (sd) total diabetes distress score 23 (21); 19% of participants with a Problem Areas In Diabetes score ≥ 40, P < 0.001). In addition to care setting, the following variables were also independently related to diabetes distress: younger age, ethnic minority status, using insulin, having a higher HbA1c level, having a higher BMI and the presence of neuropathy. Other diabetes complications were not independently associated with diabetes distress.
Conclusions
In primary care, lower levels of diabetes distress were reported than in secondary care. The difference in diabetes distress between care settings can be largely, but not fully, explained by specific demographic and clinical characteristics. These results need to be interpreted with caution as they are based on two separate studies, but do call into question the need to screen for diabetes distress in people with Type 2 diabetes in primary care.
Original languageEnglish
Pages (from-to)1252–1259
JournalDiabetic Medicine: Journal of Diabetes UK
Volume31
Issue number10
DOIs
Publication statusPublished - 2014

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Stoop, C.H. ; Nefs, G.M. ; Pop, V.J.M. ; Wijnands-van Gent, C.J. ; Tack, C.J. ; Geelhoed-Duijvestijn, P.H. ; Diamant, M. ; Snoek, F.J. ; Pouwer, F. / Diabetes-specific emotional distress in people with Type 2 diabetes : A comparison between primary and secondary care. In: Diabetic Medicine: Journal of Diabetes UK. 2014 ; Vol. 31, No. 10. pp. 1252–1259.
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title = "Diabetes-specific emotional distress in people with Type 2 diabetes: A comparison between primary and secondary care",
abstract = "AimsTo compare levels of diabetes distress in people with Type 2 diabetes treated in primary and secondary care and to examine demographic and clinical correlates that may explain potential differences in levels of distress between care settings.MethodsPeople with Type 2 diabetes from 24 primary care practices (n = 774) and three secondary care clinics (n = 526) completed the Problem Areas In Diabetes questionnaire. Data on HbA1c levels and diabetes complications were derived from medical charts. Hierarchical ordinal regression analysis was used to investigate which correlates could explain the potential differences in level of diabetes distress between care settings.ResultsDiabetes distress levels and the prevalence of elevated diabetes distress were considerably lower in the participants treated in primary care (mean (sd) total diabetes distress score 8 (11); 4{\%} of participants with a Problem Areas In Diabetes score ≥ 40) than in secondary care (mean (sd) total diabetes distress score 23 (21); 19{\%} of participants with a Problem Areas In Diabetes score ≥ 40, P < 0.001). In addition to care setting, the following variables were also independently related to diabetes distress: younger age, ethnic minority status, using insulin, having a higher HbA1c level, having a higher BMI and the presence of neuropathy. Other diabetes complications were not independently associated with diabetes distress.ConclusionsIn primary care, lower levels of diabetes distress were reported than in secondary care. The difference in diabetes distress between care settings can be largely, but not fully, explained by specific demographic and clinical characteristics. These results need to be interpreted with caution as they are based on two separate studies, but do call into question the need to screen for diabetes distress in people with Type 2 diabetes in primary care.",
author = "C.H. Stoop and G.M. Nefs and V.J.M. Pop and {Wijnands-van Gent}, C.J. and C.J. Tack and P.H. Geelhoed-Duijvestijn and M. Diamant and F.J. Snoek and F. Pouwer",
year = "2014",
doi = "10.1111/dme.12472",
language = "English",
volume = "31",
pages = "1252–1259",
journal = "Diabetic Medicine: Journal of the British Diabetic Association",
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Stoop, CH, Nefs, GM, Pop, VJM, Wijnands-van Gent, CJ, Tack, CJ, Geelhoed-Duijvestijn, PH, Diamant, M, Snoek, FJ & Pouwer, F 2014, 'Diabetes-specific emotional distress in people with Type 2 diabetes: A comparison between primary and secondary care', Diabetic Medicine: Journal of Diabetes UK, vol. 31, no. 10, pp. 1252–1259. https://doi.org/10.1111/dme.12472

Diabetes-specific emotional distress in people with Type 2 diabetes : A comparison between primary and secondary care. / Stoop, C.H.; Nefs, G.M.; Pop, V.J.M.; Wijnands-van Gent, C.J.; Tack, C.J.; Geelhoed-Duijvestijn, P.H.; Diamant, M.; Snoek, F.J.; Pouwer, F.

In: Diabetic Medicine: Journal of Diabetes UK, Vol. 31, No. 10, 2014, p. 1252–1259.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Diabetes-specific emotional distress in people with Type 2 diabetes

T2 - A comparison between primary and secondary care

AU - Stoop, C.H.

AU - Nefs, G.M.

AU - Pop, V.J.M.

AU - Wijnands-van Gent, C.J.

AU - Tack, C.J.

AU - Geelhoed-Duijvestijn, P.H.

AU - Diamant, M.

AU - Snoek, F.J.

AU - Pouwer, F.

PY - 2014

Y1 - 2014

N2 - AimsTo compare levels of diabetes distress in people with Type 2 diabetes treated in primary and secondary care and to examine demographic and clinical correlates that may explain potential differences in levels of distress between care settings.MethodsPeople with Type 2 diabetes from 24 primary care practices (n = 774) and three secondary care clinics (n = 526) completed the Problem Areas In Diabetes questionnaire. Data on HbA1c levels and diabetes complications were derived from medical charts. Hierarchical ordinal regression analysis was used to investigate which correlates could explain the potential differences in level of diabetes distress between care settings.ResultsDiabetes distress levels and the prevalence of elevated diabetes distress were considerably lower in the participants treated in primary care (mean (sd) total diabetes distress score 8 (11); 4% of participants with a Problem Areas In Diabetes score ≥ 40) than in secondary care (mean (sd) total diabetes distress score 23 (21); 19% of participants with a Problem Areas In Diabetes score ≥ 40, P < 0.001). In addition to care setting, the following variables were also independently related to diabetes distress: younger age, ethnic minority status, using insulin, having a higher HbA1c level, having a higher BMI and the presence of neuropathy. Other diabetes complications were not independently associated with diabetes distress.ConclusionsIn primary care, lower levels of diabetes distress were reported than in secondary care. The difference in diabetes distress between care settings can be largely, but not fully, explained by specific demographic and clinical characteristics. These results need to be interpreted with caution as they are based on two separate studies, but do call into question the need to screen for diabetes distress in people with Type 2 diabetes in primary care.

AB - AimsTo compare levels of diabetes distress in people with Type 2 diabetes treated in primary and secondary care and to examine demographic and clinical correlates that may explain potential differences in levels of distress between care settings.MethodsPeople with Type 2 diabetes from 24 primary care practices (n = 774) and three secondary care clinics (n = 526) completed the Problem Areas In Diabetes questionnaire. Data on HbA1c levels and diabetes complications were derived from medical charts. Hierarchical ordinal regression analysis was used to investigate which correlates could explain the potential differences in level of diabetes distress between care settings.ResultsDiabetes distress levels and the prevalence of elevated diabetes distress were considerably lower in the participants treated in primary care (mean (sd) total diabetes distress score 8 (11); 4% of participants with a Problem Areas In Diabetes score ≥ 40) than in secondary care (mean (sd) total diabetes distress score 23 (21); 19% of participants with a Problem Areas In Diabetes score ≥ 40, P < 0.001). In addition to care setting, the following variables were also independently related to diabetes distress: younger age, ethnic minority status, using insulin, having a higher HbA1c level, having a higher BMI and the presence of neuropathy. Other diabetes complications were not independently associated with diabetes distress.ConclusionsIn primary care, lower levels of diabetes distress were reported than in secondary care. The difference in diabetes distress between care settings can be largely, but not fully, explained by specific demographic and clinical characteristics. These results need to be interpreted with caution as they are based on two separate studies, but do call into question the need to screen for diabetes distress in people with Type 2 diabetes in primary care.

U2 - 10.1111/dme.12472

DO - 10.1111/dme.12472

M3 - Article

VL - 31

SP - 1252

EP - 1259

JO - Diabetic Medicine: Journal of the British Diabetic Association

JF - Diabetic Medicine: Journal of the British Diabetic Association

SN - 0742-3071

IS - 10

ER -