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

Abstract

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. 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. 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). 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.