Prevalence of diabetes distress and associated factors among patients with diabetes using antihypertensive medications in community health centres in Bandung City, Indonesia

S. Alfian, I. Wicaksono, N. A. Putri, R. Abdulah
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Abstract

Diabetes distress is common among patients with type 2 diabetes mellitus (T2DM), which remains unrecognized in primary care settings. A higher level of diabetes distress was found among T2DM patients with comorbidities. The objectives of this study are to assess the prevalence rate of diabetes distress and its association with sociodemographic factors among T2DM patients using antihypertensive medication in Bandung City, Indonesia. An observational cross-sectional survey was performed in six community health centres in Bandung City, Indonesia, among T2DM patients aged at least 18 years who were using antihypertensive medications. Diabetes distress subscales (emotional, regimen, interpersonal, and physician-related distress) were evaluated using the validated Diabetes Distress Scale. Pearson χ2 and Mann–Whitney tests were performed to assess the associations of patients’ sociodemographic factors (age, gender, insurance type, education, and duration since diagnosed with diabetes and hypertension) with diabetes distress. Of 105 patients who participated and completed the survey (response rate 93.8%), most of them were female and were aged 60-69 years. A total of 38 patients (36.2%) had moderate-high diabetes distress with emotional (56.2%) and regimen (53.3%) distress as the most commonly reported distress. Moderate-high emotional and regimen diabetes distress were significantly higher among the elderly (p 0.014) and patients who could not afford to pay the health insurance premium (p 0.012). Emotional and regimen distress as dominant forms of diabetes distress was observed among T2DM patients using antihypertensive medications. A routine diabetes distress assessment is needed in T2DM patients with comorbidity in primary care settings.
印度尼西亚万隆市社区卫生中心使用抗高血压药物的糖尿病患者糖尿病痛苦患病率及相关因素
糖尿病窘迫在2型糖尿病(T2DM)患者中很常见,但在初级保健机构中仍未被认识到。伴有合并症的2型糖尿病患者的糖尿病窘迫程度更高。本研究的目的是评估印度尼西亚万隆市使用降压药物的2型糖尿病患者的糖尿病窘迫患病率及其与社会人口因素的关系。在印度尼西亚万隆市的六个社区卫生中心进行了一项观察性横断面调查,调查对象是年龄在18岁以上且正在使用降压药物的2型糖尿病患者。糖尿病痛苦亚量表(情绪、生活方式、人际关系和医生相关的痛苦)使用经验证的糖尿病痛苦量表进行评估。采用Pearson χ2和Mann-Whitney检验来评估患者的社会人口学因素(年龄、性别、保险类型、教育程度和自诊断为糖尿病和高血压的持续时间)与糖尿病困扰的关系。105例参与并完成调查的患者(有效率93.8%),以女性居多,年龄60 ~ 69岁。共有38例患者(36.2%)存在中重度糖尿病困扰,其中情绪困扰(56.2%)和方案困扰(53.3%)是最常见的困扰。老年人和无力支付医疗保险费的患者的中高情绪困扰和糖尿病治疗方案困扰显著增加(p 0.014)。在使用降压药物的2型糖尿病患者中,情绪和方案困扰是糖尿病困扰的主要形式。在初级保健机构中,有合并症的2型糖尿病患者需要进行常规糖尿病窘迫评估。
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