Who is Distressed Applying the Diabetes Related Distress Scale in a Diabetes Clinic

The American Diabetes Association recently released a position statement on psychosocial care of patients with diabetes recommending assessment of diabetes-related distress ORD with validated scales such as the Diabetes-related Distress Scale DDS. However, there are no published data to date describing the use of the DDS in a clinical setting. We measured ORD, using the DDS, in patients enrolled to our diabetes clinic with results reported as it pertains to diabetes type and medication regimen Type 1 diabetes T1DM, Type 2 diabetes with insulin use T2DM-i, Type 2 diabetes without insulin use T2DM. Chart review, of Diabetes Center of Excellence patients, identified 810 patients who completed a baseline DDS over a 1 year period. We categorized the DDS results as follows 2.0 little or no DRD 2.0-2.9 moderate DRD and 3.0 high ORD. In addition, we evaluated four domains Emotional Burden EB Physician-related Distress PD Regimen-related Distress RD and Interpersonal Distress ID. High total DDS was most prevalent in T2DM-i patients 8.8 mean total DDS in T2DM-i 1.79 was significantly higher compared to T1DM patients 1.61 p 0.02. High RD was more prevalent in T2DM-i and T2DM groups 19.1 and 18.2, respectively, compared to patients with T1DM 11.1 with significant differences in means between T1DM 1.84 and T2DM-i 2.12 p 0.01. Although means were notstatistically different, high EB was most prevalent in T1DM and T2DM-i groups 17.4 mean 1.88 and 19.7 mean 2.09, respectively, compared to T2DM 10.8 mean 1.89. This study is the initial step to identify ORD in a clinical setting this will allow emphasis of psychosocial interventions in each diabetes group and routine reevaluation of psychosocial well-being using DDS, with the goal of improving diabetes-related outcomes. Further research is needed to assess other contributing factors related to ORD and identify interventions to reduce ORD.