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Diabetes-related distress over the course of illness: results from the Diacourse study.

Kasteleyn, M.J., Vries, L. de, Puffelen, A.L. van, Schellevis, F.G., Rijken, M., Vos, R.C., Rutten, G.E.H.M. Diabetes-related distress over the course of illness: results from the Diacourse study. Diabetic Medicine: 2015, 32(12), 1617-1624
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Aims
To investigate the relationship between diabetes duration and diabetes-related distress and to examine the impact of micro- and macrovascular complications and blood glucose-lowering treatment on this relationship.

Methods
We conducted a cross-sectional study in people with Type 2 diabetes who participated in the Dutch Diacourse study (n = 590) and completed the Problem Areas in Diabetes questionnaire. Data on diabetes duration, micro- and macrovascular complications and blood glucose-lowering treatment were collected. Multiple linear regression analysis
was used to investigate the association between diabetes duration and diabetes-related distress, and to examine whether complications and treatment could explain this association.

Results
A significant linear and quadratic association between diabetes duration and diabetes-related distress was found (duration: b = 0.27, P = 0.005; duration2: b = -0.21, P = 0.030). The association between duration and distress could be explained by microvascular complications and insulin treatment, which were both more often present in people
with a longer diabetes duration, and were associated with higher levels of diabetes-related distress (b = 0.20, P < 0.001 and b = 0.16, P = 0.006 respectively). Duration, age, gender, complications and treatment together explained 13.1% of the variance in distress.

Conclusions
Diabetes duration was associated with diabetes-related distress. This association can be explained largely by the presence of diabetes-related microvascular complications and insulin treatment. Healthcare providers should focus on distress in people with Type 2 diabetes in different stages over the course of illness, especially when complications are present or when people are on insulin treatment. As well as diabetes duration, complications and blood glucose-lowering treatment, diabetes-related distress is likely to be influenced by many other factors. (aut. ref.)