Prevalence of diabetes distress among people with type 2 diabetes in South Asia: A systematic review and meta-analysis.

IF 4.6 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-08-15 DOI:10.4239/wjd.v16.i8.109352

Abul Bashar Mohammad Kamrul-Hasan, Joseph M Pappachan, Lakshmi Nagendra, Dimuthu Muthukuda, Deep Dutta, Saptarshi Bhattacharya, Dina Shrestha, Guru Prasad Dhakal, Manilka Sumanatilleke, Syed Abbas Raza, Sanjay Kalra

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Abstract

Background: Diabetes distress (DD), an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management, is common among patients with type 2 diabetes (T2D). South Asia has a high T2D burden, and many studies have reported varying prevalence rates of DD in this area.

Aim: To estimate the pooled prevalence of DD among patients with T2D in South Asia, as it is crucial for developing effective therapeutic strategies.

Methods: This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD. The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30, 2025, using prespecified search terms. Four authors screened and extracted data independently. Meta-analyses were conducted using RStudio software with a random-effects model. The primary outcome was the pooled prevalence of DD.

Results: Thirty-seven cross-sectional studies (28 from India, five from Bangladesh, and two each from Pakistan and Sri Lanka) with mostly high methodological quality involving 11500 subjects were included. The pooled prevalence of DD was 44% (95% confidence interval: 35-53, I ² = 97.4%). The prevalence of DD was highest in Pakistan (85%), followed by India and Bangladesh (42% each), and Sri Lanka (25%). Emotional burden was the most prevalent form of DD (60%), followed by treatment regimen-related distress (51%), interpersonal distress (31%), and physician-related distress (17%). Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year, sample size, proportion of females, age, duration of diabetes, insulin usage, glycated hemoglobin levels, or diabetic complications.

Conclusion: South Asians with T2D seem to experience a relatively high burden of DD, and the emotional burden is the most common form of DD in this area. Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.

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南亚2型糖尿病患者的糖尿病困扰患病率：一项系统回顾和荟萃分析

背景：糖尿病窘迫（DD）是2型糖尿病（T2D）患者中常见的一种情绪问题，它是由糖尿病患者的生活挑战和日常自我管理的无情负担引起的。南亚有很高的T2D负担，许多研究报告了该地区DD患病率的不同。目的：估计南亚T2D患者中DD的总患病率，因为这对制定有效的治疗策略至关重要。方法：本系统综述和荟萃分析包括在南亚国家进行的涉及T2D成人的横断面研究，并报告了DD的患病率。通过使用预先指定的搜索词，从每个数据库建立之初到2025年1月30日搜索多个电子数据库和注册表，确定了这些研究。四位作者独立筛选和提取数据。meta分析采用RStudio软件，采用随机效应模型。主要结果是dd的总患病率。结果：纳入了37项横断面研究（28项来自印度，5项来自孟加拉国，巴基斯坦和斯里兰卡各2项），方法质量高，涉及11500名受试者。DD的总患病率为44%（95%置信区间：35-53，i2 = 97.4%）。DD的患病率在巴基斯坦最高（85%），其次是印度和孟加拉国（各42%）和斯里兰卡（25%）。情绪负担是DD最常见的形式（60%），其次是治疗方案相关的困扰（51%）、人际困扰（31%）和医生相关的困扰（17%）。meta回归分析显示，DD患病率与出版年份、样本量、女性比例、年龄、糖尿病病程、胰岛素使用、糖化血红蛋白水平或糖尿病并发症之间无显著关联。结论：南亚T2D患者的DD负担似乎相对较高，其中情绪负担是该地区最常见的DD形式。利用独特的工具和涉及该地区更广泛的参与者基础的更大规模的研究将为南亚国家有效规划高质量的糖尿病护理提供更好的流行病学数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.