# Prevalence and associated factors of high-level diabetes-related distress among patients with type 2 diabetes mellitus in northern Malaysian primary care settings: A cross-sectional study

## TL;DR

This study found that about 13.6% of type 2 diabetes patients in northern Malaysia experience high diabetes-related distress, with obesity and lack of transportation being key factors.

## Contribution

The study identifies specific sociodemographic and clinical factors associated with high diabetes-related distress in a Malaysian primary care population.

## Key findings

- The prevalence of high-level diabetes-related distress was 13.6% among participants.
- Obese patients had higher odds of high distress, while those with nephropathy had lower odds.
- Patients who attended clinics independently had lower distress compared to those using public transport.

## Abstract

Diabetes-related distress (DRD) affects disease control and quality of life. This study aimed to determine the prevalence of high-level DRD, compare the prevalence according to diabetes complications and identify the associated sociodemographic and clinical factors.

This cross-sectional study included 198 participants from three primary care clinics in northern Malaysia from 1 May 2023 to 31 July 2023. DRD was measured using the 17-Item Diabetes Distress Scale, with a score of >3 indicating high-level distress. Multiple logistic regression was used to assess the association between the sociodemographic and clinical characteristics and DRD.

The prevalence of high-level DRD was 13.6%. The prevalence was significantly higher among the patients without nephropathy (17.2%) than among those with nephropathy (3.8%) (P=0.014) but did not significantly differ among those with other complications. Those who attended the clinics independently were less likely to be highly distressed than those using public transportation or sent by others (adjusted odds ratio [aOR]=0.31, 95% confidence interval [CI]=0.10–0.99, P=0.048). The participants who were obese (aOR=2.96, 95% CI=1.08-8.08, P=0.034) had higher odds of having high-level DRD than those who were not, while those who had nephropathy (aOR=0.11, 95% CI=0.02-0.58, P=0.010) had lower odds of having high-level DRD than those who did not.

The overall prevalence of high-level DRD is relatively low but significantly higher among individuals without nephropathy. 0besity, lack of transportation and the absence of nephropathy are positively associated with high-level DRD and should therefore be a focus of psychological support and intervention.