High rates of elevated diabetes distress in research populations: A systematic review and meta-analysis

Diabetes distress has implications for diabetes end-points, hence targeted interventions are indicated; yet, preliminary work quantifying and characterising the problem is required. We sought to identify the potential magnitude and determinants of elevated diabetes distress across study populations. Databases such as Medline, PsycINFO and Embase were searched for studies (n ≥50) administering the problem areas in Diabetes scale or Diabetes Distress scale, in adults with Type 1 or 2 diabetes. Random effects meta-analysis and meta-regression estimated the average rate of elevated diabetes distress and prognostic contribution of age, gender, HbA1c, and health-care context. Of the 16,627 citations identified, adequate data were available for 58 studies. On average, 22% of participants reported elevated diabetes distress. Only female gender and secondary care predicted a higher rate of elevated diabetes distress. A quarter of people with diabetes have a level of distress likely to impact outcomes. Secondary-care practitioners should be vigilant of women with diabetes.

糖尿病痛苦（Diabetes Distress）对糖尿病终点事件存在影响，提示需实施针对性干预措施；但当前仍需开展量化并表征该问题的前期研究。本研究旨在明确不同研究人群中升高的糖尿病痛苦的潜在规模及其决定因素。我们检索了MEDLINE、PsycINFO及Embase等数据库，纳入针对1型或2型糖尿病成年患者、采用糖尿病问题领域量表（Problem Areas in Diabetes scale）或糖尿病痛苦量表（Diabetes Distress scale）、样本量≥50的相关研究。采用随机效应meta分析与meta回归，估算了升高的糖尿病痛苦的总体发生率，以及年龄、性别、糖化血红蛋白（HbA1c）与医疗环境对其的预后贡献。在检索到的16627条文献线索中，最终有58项研究提供了可用的完整数据。平均来看，22%的受试者报告存在程度升高的糖尿病痛苦。仅女性性别与二级医疗环境可预测更高的糖尿病痛苦发生率。四分之一的糖尿病患者的痛苦程度足以对疾病结局产生影响。二级医疗从业者应警惕糖尿病女性患者的相关风险。