Affiliation:
1. NYU Grossman School of Medicine
2. San Francisco State University
Abstract
Abstract
Background: Type 2 diabetes (T2D) disproportionately affects South Asians in the United States (US). Living with T2D can be challenging due to the distress it can create for an individual. Distress associated with diabetes, commonly known as diabetes distress (DD), may lead to complications and challenges with the management of diabetes. This study aims to describe the prevalence of DD among a sample of South Asians in New York City (NYC) seeking care in community-based primary care settings and its association with sociodemographic characteristics and clinical measures.
Methods: This study utilized baseline data from the Diabetes Research, Education, and Action for Minorities (DREAM) Initiative, an intervention designed to reduce hemoglobin A1C (HbA1c) among South Asians with uncontrolled T2D in NYC. DD was measured using the Diabetes Distress Scale (DDS). First, descriptive statistics were used to analyze sociodemographic variables. Chi-square tests assessed categorical variables and Wilcoxon Rank Sum tests assessed continuous variables using a Type I error rate of 0.05. Logistic regression was performed to determine if HbA1c and mental health, along with other covariates, were associated with dichotomized DDS subscales.
Results: Overall, 415 participants completed the DDS at baseline. Median age was 56 years (IQR: 48-62). A total of 25.9% had high emotional burden distress, 6.6% had high physician-related distress, and 22.2% had high regimen-related distress based on subscales. In adjusted analyses, individuals with any days of poor mental health had significantly higher odds of overall distress (OR:3.7, p=0.014), emotional burden distress (OR:4.9, p<0.001), and physician-related distress (OR:5.0, p=0.002) compared to individuals with no days of poor mental health. Individuals with higher HbA1c had significantly higher odds of regimen-related distress (OR:1.31, p=0.007).
Conclusions: Findings suggest that DD is prevalent among this sample of South Asians with diagnosed T2D in NYC. Screening for DD in patients with prediabetes/diabetes should be considered by providers to help provide mental and physical health services during primary care visits. Future research can also benefit from a longitudinal analysis of the impact of DD on diabetes self-management, medication adherence, and mental and physical health.
Trial registration: This study uses baseline data from “Diabetes Management Intervention For South Asians” (NCT03333044), which was registered with clinicaltrials.gov on 6/11/2017.
Publisher
Research Square Platform LLC
Reference54 articles.
1. 1. How Effective Were Lifestyle Interventions In Real-World Settings That Were Modeled On The Diabetes Prevention Program? | Health Affairs Journal. Health Aff (Millwood) [Internet]. [cited 2022 Aug 23]; Available from: http://www.healthaffairs.org/doi/10.1377/hlthaff.2011.1009
2. 2. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of Childhood and Adult Obesity in the United States, 2011–2012. JAMA. 2014 Feb 26;311(8):806–14.
3. 3. Thorpe LE, Upadhyay UD, Chamany S, Garg R, Mandel-Ricci J, Kellerman S, et al. Prevalence and Control of Diabetes and Impaired Fasting Glucose in New York City. Diabetes Care. 2009 Jan 1;32(1):57–62.
4. 4. Demographic Information | SAALT [Internet]. [cited 2022 Aug 23]. Available from: https://saalt.org/south-asians-in-the-us/demographic-information/
5. 5. Ethnic Profiles [Internet]. Asian American Federation. [cited 2022 Aug 23]. Available from: https://www.aafederation.org/aaf-our-work/census-center/ethnic-profiles/