Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 23

23 - PSYCHOLOGICAL IMPACT AND DISTRESS IN LEADING A LIFE WITH TYPE 2 DIABETES MELLITUS

Thursday, Apr 25
11:30 AM – 12:00 PM

Objective :

The world’s second largest population of diabetes is in India. Psychological issues like depression and diabetes-related distress have not been systematically investigated in Indians with type 2 diabetes (T2D). We sought to evaluate the amount of diabetes-related distress in T2D patients.


Methods :

We included 414 consecutive T2D patients attending Endocrinology outpatient department. Diabetes Distress Scale(DDS) questionnaire was used to assess total diabetes distress and subscales for assessing emotional distress, interpersonal distress, regimen-related distress and physician distress. This scale is well validated and has been used in South Asians in Canada. Initially a 2-item screener was administered and those who had score of 3 or more were put through full 17-point DDS questionnaire(DDS17).


Results :

The rate of total diabetes distress was 42.3%(175 of 414 T2D patients). Of 175 patients having significant distress, subscale parameters were studied. The rate of emotional burden and regimen related distress was seen in 115(65%) and 50(28%) patients respectively. 14(8%) patients had physician related distress and 28(16%) patients had interpersonal distress. 


Regimen related distress was seen in 28(56.0%) males and 22(44%) females. Emotional burden and Physician related distress were similar in both males and females: 58(50.4%) versus 57(49.5%) and  7(50.0%) versus 7(50.0%) respectively. Interpersonal distress was present in 13(46.4%) males and 15(53.6%) females.


These patients had mean fasting blood sugar of 147.4+53.7mg/dl, post prandial blood sugar of 240.4+91.9mg/dl and HbA1c of 8.60+1.92%. The glycemic control parameters however did not correlate with rates of diabetes distress.


Discussion :

The first study to report that diabetes distress is a serious concern for South Asian Canadians was published in 2016 in Canadian Journal of Diabetes. The rate of total diabetes distress was 52.5% and did not correlate with HbA1C levels in their study. In our study total diabetes distress was significant although lesser at 42.3%. In the Candian study the rate of clinical depression was 15% as compared to just 5.3% in our study.


Conclusion :

Diabetes-related distress is a significant concern for Indians with type 2 diabetes. Emotional burden and Regimen-related burden predominate. Emotional burden is similar in males and females. Despite a lower doctor to patient ratio in India, physician related distress is the least contributor among subparameters. Understanding diabetes distress with  larger sample size from diverse regions of India may help in understanding psychological issues that may impact diabetes management.

SHORT URL FUNCTION-->

Madhukar Mittal

Ass Professor & Head
Department of Endocrinology, KG Medical University
Lucknow, Uttar Pradesh, India

Current Position:
1. Associate Professor, KGMU, Lucknow
2. Head, Department of Endocrinology, KGMU

Clinical Work:
1. Running a successful Endocrinology and Diabetes OPD and a Pediatric Endocrinology OPD

Lab Work:
1. Instrumental in running the Endocrine Laboratory at KGMU.
2. POC services started in Endocrinology OPD for comprehensive single-point check-up of a diabetic patient

Research:
1. Researcher with both national and international publications
2. Has presented several papers in National and International conferences and also chaired several sessions. Keen researcher and an excellent speaker.

Positions Held:

1. Member, Telemedicine Unit, KGMU, Lucknow
2. Member DOTS Plus Site Committee (DR-TB Centre), KGMU, as Endocrinologist.
3. Faculty for CCEBDM and CCGDM courses of PHFI


Awards / Academic Achievements
1. Dr.NN Gupta Award, Silver medal, UPICON-2004
2. Deeptanshu Vedant Gupta Quiz, 2nd prize, UPICON-2004
3. Recipient of NCERT scholarship
4. UPDA Award. Padmakar Tripathi, Young Investigator Award, November 2014
5. Travel Grant from ISPAD to Brisbane, Australia, October 2015.
6. Founder member of UPISBMR
7. Nodal Officer of KGMU for Diabetes India Initiative
8. Member, Subject Expert Committee (SEC)-Endocrinology to DCGI for approval of New Drugs and Clinical Trials

Society Memberships:

1. Member International Endocrine Society, EASD, AACE
2. Life Member Endocrine Society of India (ESI), RSSDI-National & UP, ISBMR, Indian Thyroid Society (ITS), API, IMA, UPDA, UP-API, Associate Member, ISPAE.

Pratishtha Mishra

Research Associate
Department of Endocrinology, KG Medical University, India

Well versed with research systems and analysis. Has contributed to design and conduct of Endocrine research.

Namrata Gupta

Research Assistant
Department of Endocrinology, KG Medical University, Uttar Pradesh, India

Helping in design and conduct of Endocrine research.

Anoop Kumar

Diabetes Nurse Educator
Department of Endocrinology, KG Medical University, Uttar Pradesh, India

Deals directly with diabetes patients for education and research

Pooja Patel

Diabetic Nurse Educator
Department of Endocrinology, KG Medical University

Deals directly with diabetic patients in education and research.

Naresh Maurya

Resident
Department of Endocrinology, KG Medical University

Team member in running the diabetic OPD and treating patients. Helps in conduct of clinical trials and research.

Madhukar Mittal

Ass Professor & Head
Department of Endocrinology, KG Medical University
Lucknow, Uttar Pradesh, India

Current Position:
1. Associate Professor, KGMU, Lucknow
2. Head, Department of Endocrinology, KGMU

Clinical Work:
1. Running a successful Endocrinology and Diabetes OPD and a Pediatric Endocrinology OPD

Lab Work:
1. Instrumental in running the Endocrine Laboratory at KGMU.
2. POC services started in Endocrinology OPD for comprehensive single-point check-up of a diabetic patient

Research:
1. Researcher with both national and international publications
2. Has presented several papers in National and International conferences and also chaired several sessions. Keen researcher and an excellent speaker.

Positions Held:

1. Member, Telemedicine Unit, KGMU, Lucknow
2. Member DOTS Plus Site Committee (DR-TB Centre), KGMU, as Endocrinologist.
3. Faculty for CCEBDM and CCGDM courses of PHFI


Awards / Academic Achievements
1. Dr.NN Gupta Award, Silver medal, UPICON-2004
2. Deeptanshu Vedant Gupta Quiz, 2nd prize, UPICON-2004
3. Recipient of NCERT scholarship
4. UPDA Award. Padmakar Tripathi, Young Investigator Award, November 2014
5. Travel Grant from ISPAD to Brisbane, Australia, October 2015.
6. Founder member of UPISBMR
7. Nodal Officer of KGMU for Diabetes India Initiative
8. Member, Subject Expert Committee (SEC)-Endocrinology to DCGI for approval of New Drugs and Clinical Trials

Society Memberships:

1. Member International Endocrine Society, EASD, AACE
2. Life Member Endocrine Society of India (ESI), RSSDI-National & UP, ISBMR, Indian Thyroid Society (ITS), API, IMA, UPDA, UP-API, Associate Member, ISPAE.