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Diabetes distress and diabetes burnout explored in various areas of life in patients with type 1 diabetes: effect of short-term psychological intervention

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Abstract

Introduction

Diabetes distress (DD) and diabetes burnout (DB) are recognized psychological phenomena in patients with T1DM (type 1 diabetes mellitus). Still, there is an urgent need to create professional psychological intervention procedures to provide patients with adequate care.

Aim

The aim of the study was to assess the level of DD and DB in T1DM patients at baseline and after 5 of sessions psychological intervention in the group of participants who applied for help.

Methods

34 T1DM patients who requested psychological support (22 females, 12 males) and 30 patients in a control group (14 females, 16 males) participated in the study. At baseline clinical test results between groups were compared. Next, in the studied group measurements were repeated after a set of five psychological face-to-face individual interventions which lasted 30–60 min each. They were support sessions with elements of cognitive-behavioral interventions done by clinical psychologists. Session 1: introduction, interview and collection of test results; session 2–4: work on the indicated by the patient and test results most problematic aspect of diabetes, session 5: a summary and plan for further treatment if needed. The control group results were obtained only at baseline. Research tools: DDS; PAID, Diabetes Burnout test by Polonsky.

Results

At the baseline, significant differences were observed between the studied group and control group: in DB/DD levels: DB (3.9 ± 1.7 vs 2.4 ± 1.6; p < 0.001); DDS (3.2 ± 1.0 vs 2.7 ± 1.0; p = 0.064); PAID (62.3 ± 14.1vs 34.4 ± 21.0; p < 0.001). There were also group differences in HbA1c levels (8.7 ± 2.4 vs 7.3 ± 1.5; p = 0.028). After psychological interventions, there was a significant improvement in DB (3.9 ± 1.7vs 2.9 ± 1.2; p < 0.001; DDS (3.2 ± 1 vs 3.0 ± 0.7; p = 0.03); PAID (62.3 ± 14.1 vs 51.8 ± 12.5; p < 0.001).

Conclusions

DD and DB constitute a significant problem in the group of T1DM patients, but providing appropriate specialist care may help them accept diabetes and improve life satisfaction, as well as regain control over their diabetes management.

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Data availability

The data that support the findings of this study are available on request from the corresponding author K.C.

References

  1. T.C. Skinner, L. Joensen, T. Parkin, Twenty-five years of diabetes distress research. Diabet. Med. 37(3), 393–400 (2020). https://doi.org/10.1111/dme.14157

    Article  CAS  PubMed  Google Scholar 

  2. F. Snoek, Mental health in diabetes care. Time to step up. Front. Clin. Diabetes Healthc., 13, https://doi.org/10.3389/fcdhc.2022.1039192

  3. K. Dennick, J. Sturt, J. Speight, What is diabetes distress and how can we measure it? A narrative review and conceptual model. J. Diabetes Complic. 31(5), 898–911 (2017). https://doi.org/10.1016/j.jdiacomp.2016.12.018

    Article  Google Scholar 

  4. W.H. Polonsky, L. Fisher, J. Earles, R.J. Dudl, J. Lees, J. Mullan, R.A. Jackson, Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care 28(3), 626–631 (2005). https://doi.org/10.2337/diacare.28.3.626

    Article  PubMed  Google Scholar 

  5. S. Abdoli, D. Hessler, B. Smither, K. Miller-Bains, E.M. Burr, H.L. Stuckey, New insights into diabetes burnout and its distinction from diabetes distress and depressive symptoms: a qualitative study. Diabetes Res Clin. Pract. 169, 108446 (2020). https://doi.org/10.1016/j.diabres.2020.108446

    Article  PubMed  Google Scholar 

  6. K. Kontoangelos, A. Raptis, V. Lambadiari, M. Economou, S. Tsiori, V. Katsi, C. Papageorgiou, S. Martinaki, G. Dimitriadis, C. Papageorgiou, Burnout related to diabetes mellitus: a critical analysis. Clin. Pract. Epidemiol. Ment. Health 18, e174501792209010 (2022). https://doi.org/10.2174/17450179-v18-e2209010

    Article  PubMed  PubMed Central  Google Scholar 

  7. American Diabetes Association Professional Practice Committee, B. Draznin, A. VR, G. Bakris, G. Benson, B. FM et al. Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes-2022. Diabetes Care 45(Suppl 1), S60–S82 (2022). https://doi.org/10.2337/dc22-S005

    Article  Google Scholar 

  8. E.H. Lee, Y.W. Lee, K.W. Lee et al. Measurement of diabetes-related emotional distress using the Problem Areas in Diabetes scale: psychometric evaluations show that the short form is better than the full form. Health Qual. Life Outcomes 12, 142 (2014). https://doi.org/10.1186/s12955-014-0142-z

    Article  PubMed  PubMed Central  Google Scholar 

  9. G.W. Welch, A.M. Jacobson, W.H. Polonsky, The problem areas in Diabetes Scale. An evaluation of its clinical utility. Diabetes Care 20(5), 760–766 (1997). https://doi.org/10.2337/diacare.20.5.760. MayPMID: 9135939

    Article  CAS  PubMed  Google Scholar 

  10. S. Krzemińska, E. Bąk, Psychometric properties of the Polish Version of the Diabetes Distress Scale (DDS). Psychol. Res Behav. Manag. 14, 1149–1156 (2021). https://doi.org/10.2147/PRBM.S320675

    Article  PubMed  PubMed Central  Google Scholar 

  11. Novo Nordisk 2006. Adapted from DAWN Interactive 2. Text by Frank Snoek and Garry Welch

  12. Diabetes burnout: what to do when you can’t take it anymore, William Polonsky, American Diabetes Association, 1999, ISBN 1580403905, 9781580403900

  13. K. Cyranka, D. Dudek, M.T. Małecki, B. Matejko, T. Klupa, Psychological crisis intervention for COVID-19 lockdown stress in patients with type 1 diabetes mellitus: survey study and qualitative analysis. JMIR Ment. Health 8(6), e28097 (2021). https://doi.org/10.2196/28097

    Article  PubMed  PubMed Central  Google Scholar 

  14. K. Cyranka, B. Matejko, A. Chrobak, D. Dudek, B. Kieć-Wilk, K. Cyganek, P. Witek, M. Lushchyk, S. Krzyżowska, M.T. Małecki, T. Klupa, Assessment of the spectrum of depression and bipolarity in patients with type 1 diabetes. Diabetes Metab. Res. Rev. 21, e3583 (2022). https://doi.org/10.1002/dmrr.3583

    Article  CAS  Google Scholar 

  15. V. Hagger, C. Hendrieckx, F. Cameron, F. Pouwer, T.C. Skinner, J. Speight, Diabetes distress is more strongly associated with HbA1c than depressive symptoms in adolescents with type 1 diabetes: results from Diabetes MILES Youth-Australia. Pediatr. Diabetes 19(4), 840–847 (2018). https://doi.org/10.1111/pedi.12641

    Article  CAS  PubMed  Google Scholar 

  16. A.M. Friis, M.H. Johnson, R.G. Cutfield, N.S. Consedine, Does kindness matter? Self-compassion buffers the negative impact of diabetes-distress on HbA1c. Diabet. Med 32(12), 1634–1640 (2015). https://doi.org/10.1111/dme.12774

    Article  CAS  PubMed  Google Scholar 

  17. A. Fayed, F. AlRadini, R.M. Alzuhairi, A.E. Aljuhani, H.R. Alrashid, M.M. Alwazae, N.R. Alghamdi, Relation between diabetes related distress and glycemic control: The mediating effect of adherence to treatment. Prim. Care Diabetes 16(2), 293–300 (2022). https://doi.org/10.1016/j.pcd.2021.12.004

    Article  PubMed  Google Scholar 

  18. L. Lašaitė, R. Dobrovolskienė, E. Danytė, I. Stankutė, D. Ražanskaitė-Virbickienė, V. Schwitzgebel, D. Marčiulionytė, R. Verkauskienė, Diabetes distress in males and females with type 1 diabetes in adolescence and emerging adulthood. J. Diabetes Complic. 30(8), 1500–1505 (2016). https://doi.org/10.1016/j.jdiacomp.2016.08.013

    Article  Google Scholar 

  19. I. Nishio, M. Chujo, Self-stigma of patients with type 1 diabetes and their coping strategies. Yonago Acta Med. 60(3), 167–173 (2017)

    Article  PubMed  PubMed Central  Google Scholar 

  20. Y.M. Jeong, L. Quinn, N. Kim, P. Martyn-Nemeth, Health-related stigma in young adults with type 1 diabetes mellitus. J. Psychosoc. Nurs. Ment. Health Serv. 56(10), 44–51 (2018). https://doi.org/10.3928/02793695-20180503-01

    Article  PubMed  Google Scholar 

  21. J. Fuchs, R. Hovorka, Closed-loop control in insulin pumps for type-1 diabetes mellitus: safety and efficacy. Expert Rev. Med. Devices 17(7), 707–720 (2020)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. A. Janez, T. Battelino, T. Klupa, G. Kocsis, M. Kuricová, N. Lalić, A.P. Stoian, M. Prázný, D. Rahelić, J. Šoupal, T. Tankova, N. Zelinska, Hybrid closed-loop systems for the treatment of type 1 diabetes: a collaborative, expert group position statement for clinical use in Central and Eastern Europe. Diabetes Ther. 12(12), 3107–3135 (2021)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. B. Matejko, A. Juza, B. Kieć-Wilk, K. Cyranka, S. Krzyżowska, X. Chen, O. Cohen, J. Da Silva, M.T. Malecki, T. Klupa, Transitioning of people with type 1 diabetes from multiple daily injections and self-monitoring of blood glucose directly to minimed 780g advanced hybrid closed-loop system: a two-center, randomized, controlled study. Diabetes Care 45(11), 2628–2635 (2022). https://doi.org/10.2337/dc22-0470

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. V. Serrano, L. Larrea-Mantilla, R. Rodríguez-Gutiérrez, G. Spencer-Bonilla, G. Málaga, I. Hargraves, V.M. Montori, Shared decision making in patients with diabetes mellitus. Rev. Med Chil. 145(5), 641–649 (2017). https://doi.org/10.4067/S0034-98872017000500012

    Article  PubMed  Google Scholar 

  25. N. Hermanns, D. Ehrmann, A. Shapira, B. Kulzer, A. Schmitt, L. Laffel, Coordination of glucose monitoring, self-care behaviour and mental health: achieving precision monitoring in diabetes. Diabetologia. 2022. https://doi.org/10.1007/s00125-022-05685-7

  26. V. Serrano, R. Rodriguez-Gutierrez, I. Hargraves, M.R. Gionfriddo, S. Tamhane, V.M. Montori, Shared decision-making in the care of individuals with diabetes. Diabet. Med 33(6), 742–751 (2016). https://doi.org/10.1111/dme.13143

    Article  CAS  PubMed  Google Scholar 

  27. S. Tamhane, R. Rodriguez-Gutierrez, I. Hargraves, V.M. Montori, Shared decision-making in diabetes care. Curr. Diabetes Rep. 15(12), 112 (2015). https://doi.org/10.1007/s11892-015-0688-0

    Article  Google Scholar 

  28. J. Carretero-Gómez, J.C. Arévalo-Lorido, The meaning of words in diabetes. Language matters. Rev. Clin. Esp. 222(8), 502–503 (2022). https://doi.org/10.1016/j.rceng.2022.07.003

    Article  PubMed  Google Scholar 

  29. N. Kuniss, U.A. Müller, C. Kloos, G. Wolf, G. Kramer, Reduction of HbA1c and diabetes-related distress after intervention in a diabetes day care clinic in people with type 2 diabetes but not with type 1 diabetes. Exp. Clin. Endocrinol. Diabetes 126(4), 242–248 (2018). https://doi.org/10.1055/s-0043-112862

    Article  CAS  PubMed  Google Scholar 

  30. V.S. Helgeson, Diabetes burnout among emerging adults with type 1 diabetes: a mixed methods investigation. J. Behav. Med. 44(3), 368–378 (2021). https://doi.org/10.1007/s10865-020-00198-3

    Article  PubMed  Google Scholar 

  31. E. Berry, S. Lockhart, M. Davies, J.R. Lindsay, M. Dempster, Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies. Postgrad. Med. J. 91(1075), 278–283 (2015). https://doi.org/10.1136/postgradmedj-2014-133017

    Article  PubMed  Google Scholar 

  32. J.S. Gonzalez, M.L. Tanenbaum, P.V. Commissariat, Psychosocial factors in medication adherence and diabetes self-management: Implications for research and practice. Am. Psychol. 71(7), 539–551 (2016). https://doi.org/10.1037/a0040388

    Article  PubMed  PubMed Central  Google Scholar 

  33. K. Winkley, R. Upsher, D. Stahl, D. Pollard, A. Kasera, A. Brennan, S. Heller, K. Ismail, Psychological interventions to improve self-management of type 1 and type 2 diabetes: a systematic review. Health Technol. Assess. 24(28), 1–232 (2020). https://doi.org/10.3310/hta24280

    Article  PubMed  PubMed Central  Google Scholar 

  34. P. Khashayar, N. Shirzad, A. Zarbini, A. Esteghamati, M. Hemmatabadi, E. Sharafi, Diabetes-related distress and its association with the complications of diabetes in Iran. J. Diabetes Metab. Disord. 21(2), 1569–1575 (2022). https://doi.org/10.1007/s40200-022-01103-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. A. Stahl-Pehe, C. Bächle, K. Bódis, O.P. Zaharia, K. Lange, R.W. Holl, M. Roden, J. Rosenbauer; GDS Group, Comparison of diabetes distress and depression screening results of emerging adults with type 1 diabetes onset at different ages: findings from the German early-onset T1D study and the German Diabetes Study (GDS). Diabetol. Metab. Syndr. 15(1), 24 (2023). https://doi.org/10.1186/s13098-023-00994-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Funding

Jagiellonian University Medical College grant no N41/DBS/000642.

Author information

Author notes

  1. Maciej T. Malecki

    Present address: Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland

Authors and Affiliations

  1. Department of Psychiatry, Jagiellonian University Medical College, Kraków, Poland

    Katarzyna Cyranka, Maciej Pilecki, Andrzej Juryk & Dominika Dudek

  2. Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland

    Katarzyna Cyranka, Tomasz Klupa & Bartłomiej Matejko

  3. University Hospital in Krakow, Kraków, Poland

    Katarzyna Cyranka, Tomasz Klupa, Maciej Pilecki, Dominika Sarna-Palacz, Andrzej Juryk, Dawid Storman, Dominika Dudek, Maciej T. Malecki & Bartłomiej Matejko

  4. Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Kraków, Polska

    Dawid Storman

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  1. Katarzyna Cyranka
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Correspondence to Katarzyna Cyranka.

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The study received Jagiellonian University Medical College No. 1072.6120.78.202. Participants gave their informed consent to participate and consent to publish the study.

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Cyranka, K., Klupa, T., Pilecki, M. et al. Diabetes distress and diabetes burnout explored in various areas of life in patients with type 1 diabetes: effect of short-term psychological intervention. Endocrine (2024). https://doi.org/10.1007/s12020-024-03760-0

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