Original Article Prevalence and determinants of diabetes distress in patients of diabetes mellitus in a tertiary care centre Deepak Gahlan a , Rajesh Rajput a , Pratibha Gehlawat b, *, Rajiv Gupta b a Department of Endocrinology & Medicine V, Pt. B.D.S. PGIMS, Rohtak, Haryana, India b Department of Psychiatry, Pt. B.D.S. PGIMS, Rohtak, Haryana, India A R T I C L E I N F O Article history: Available online xxx Keywords: Diabetes mellitus Diabetes distress Prevalence Predictors A B S T R A C T Background: Patients of diabetes mellitus experience psychological difficulties associated with their disease which remains unrecognized involving several states related to coping with diabetes. Diabetes distress is a distinct condition which is often mistaken for depression and is related to adverse disease outcomes. Aims and objective: To study the prevalence and predictors of diabetes distress in patients of Type 2 Diabetes mellitus (T2DM) in a tertiary care centre. Materials and methods: This cross-sectional study was conducted over a period of one year at Endocrine OPD of Pt. B.D. Sharma PGIMS, Rohtak, a tertiary care centre in northern India. 410 consecutive patients having T2DM attending the endocrine OPD were screened for psychiatric disorders and 189 diabetic patients with no underlying psychiatric disorders were included in the study. Their socio-demographic and relevant clinical variables were recorded. Diabetes Distress Scale (DDS) was used to measure distress due to the disease in these patients. Results: It was found that the prevalence of diabetes distress was 18.0%; among them 16.1% had emotion related distress, 5.6% regimen related distress, 1.5% interpersonal related distress and 1.2% physician related diabetes distress. The major predictors for high diabetes distress scores among diabetic cases were low education level, retinopathy, neuropathy and hypertension. Conclusion: The present study suggests that emotion related diabetes distress was more prevalent among diabetic patients. Lower education level and the presence of diabetic complications contribute as risk factors for high diabetes distress. © 2017 Published by Elsevier Ltd on behalf of Diabetes India. 1. Introduction Diabetes is one of the most common metabolic disorders in the world. India has the largest number of diabetic population in the world and there will be more than 123 million diabetic population in India by 2040 [1]. Diabetic patient experience many psychiatric co-morbidity that are significantly associated with impaired health-related quality of life, more days off work, non-adherence, and difficulties with diabetes self-care [2]. It has been well understood that there is strong association between diabetes and depression Recently, it has been documented that diabetes-specific distress is not uncommon in patients of diabetes due to chronic course of the illness. Diabetes distress is a disease-specific problem encountered among diabetic patients and related to diabetes outcomes [3]. Diabetes distress refers to the unique, often hidden emotional burdens and worries that are part of the spectrum of the patient experience, when managing a severe, demanding chronic disease, like diabetes [4]. Diabetes distress remains persistent over time and is found to be distinct from clinical depression in linkage with disease management [5–8]. Previous reports have suggested that most patients with high depressive affect are not necessarily clinically depressed, but rather they are suffering from high levels of diabetes-related distress [5,6]. The prevalence of diabetes distress has been reported ranging from 18 to 35% [3,5–8]. It was found that 17.2% diabetic patients without diabetes distress at initial assessment, reported high diabetes distress during the following 18 months [3]. It is not only burdensome itself but also it can impede the self caring behavior of patients, thereby compromising glycemic control as compared to non-depressed and non-distressed [6,9]. It has also been suggested that diabetes distress, not clinical depression or depressive symptoms is significantly and positively associated with glycaemic control [7]. Hoorn study showed that worsening glucose metabolism is * Corresponding author. E-mail address: pratibhagehlawat2017@gmail.com (P. Gehlawat). https://doi.org/10.1016/j.dsx.2017.12.024 1871-4021/© 2017 Published by Elsevier Ltd on behalf of Diabetes India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews xxx (2017) xxx–xxx G Model DSX 907 No. of Pages 4 Please cite this article in press as: D. Gahlan, et al., Prevalence and determinants of diabetes distress in patients of diabetes mellitus in a tertiary care centre, Diab Met Syndr: Clin Res Rev (2018), https://doi.org/10.1016/j.dsx.2017.12.024 Contents lists available at ScienceDirect Diabetes & Metabolic Syndrome: Clinical Research & Reviews journal homepa ge: www.elsev ier.com/locate/dsx