Diabetes impacts on mental health. We investigated patient characteristics of those most at risk and consequences for glycaemic control.
Depression (PHQ-9) , Diabetes Distress Screening Scale (DDSS) and Quality of Life (EQ5D) on-line questionnaires were completed by people with diabetes and linked to data extracted data from responders’ clinical records. Sources of distress were also considered through evaluating sub-scales Emotional, Physician, Regimen and Interpersonal DDSS scores.
130 responses with 34% T1DM, 56% women, median age 59 (IQR47-67) years were recorded. The median scores were EQ5D=0.74 (IQR 0.64 - 0.85) UK median 0.83; DDSS=1.9 (IQR1.3-2.7) (≥2 indicates moderate distress) and PHQ9=5 (IQR2-11) (≥5 indicates depression) .
Higher DDSS/lower EQ5D5L/higher PHQ-9 within the response group were linked to female sex (DDSS 0.5/25% above median) , younger age (<50years DDSS 0.7/35% above median) , fewer years after diagnosis (<10years DDSS 0.8/40% above median) , and obesity (BMI>35 DDSS 0.6/30% above median) .
33 people with good (HbA1c≤48mmol/mol) or improving glycaemic control (HbA1c reduced by 2mmol/mol since previous reading) had higher DDSS = 2.4 versus the others = 1.9.
The link between individual DDSS and PHQ-9 scores was significant r2=0.4, while the association to EQ5D was less r2=0.11. For 30 people with history of anti-depressant medication use, DDSS was 0.9/45% above median, showing medical diagnosis confirmed self-reported distress.
DDSS scores did not significantly link to diabetes type or insulin use.
Physician related DDSS higher scores came from women, younger age, overweight, early years after diagnosis, plus history of antidepressant use. This is potentially remediable.
Level of distress is associated/maybe required in achieving and maintaining lower HbA1c. The impact on mental health of younger women/people with shorter diabetes duration should be noted when considering psychosocial intervention/behaviour change messaging.
A. H. Heald: None. U. Waheed: None. M. Stedman: None. A. N. Paisley: None. E. Solomon: None.