Diabetes distress and related factors amongst type 2 diabetic patients attending primary health care facilities in Ekurhuleni Health District, Gauteng

Abstract

Background: Diabetes distress is common worldwide with a prevalence of nearly 40% in patients with Diabetes Mellitus. Many previous studies have shown that factors such as younger age, high body mass index, poor diet, and poor health care provider support may contribute to diabetes distress. The aim of this study was to identify the factors contributing to diabetes distress amongst patients with diabetes, attending peri-urban public primary health care facilities in South Africa.Methods: A cross-sectional study using a self-administered questionnaire. Data was collected over a four month period from May to August 2018 from the two chosen facilities. Data were analysed using STATA, Release 15.0. Descriptive statistics was used to get frequencies and percentages. Chi-square tests and logistic regression was used to test associations between variables. Results: Out of the 671 participants included in this study: some 36.8% of the participants were found to be distressed; with moderate distress (24.29%); and severe distress (12.52%). Amongst the distressed participants, emotional distress was the highest (74.8%) and physician related distress was the lowest (21.05%). There was a statistically significant association between employment (p=0.012), mode of treatment (p=0.016), frequency of glucose checks (p=0.000) and level of distress. On multivariate regression analysis, those who were unemployed (OR = 1.56; 95% CI 1.05; 5.20) or retired (OR = 2.84; 95% CI 1.56; 5.20) and on both injections and oral medications (OR = 1.74; 95% CI 1.13; 2.69) were found to be more distressed. Conclusion: High levels of distress were detected amongst the diabetic population attending primary health care facilities in the peri-urban setting. Therefore, there is a need to create awareness amongst health care providers, improve screening and early detection of diabetes distress to improve overall patient outcomes.