# Diabetes distress among adults with type 2 diabetes mellitus in the North of West Bank-Palestine

## TL;DR

This study examines diabetes distress in adults with type 2 diabetes in the North of West Bank, finding it is common and influenced by factors like comorbidities and socioeconomic conditions.

## Contribution

The study provides new insights into diabetes distress prevalence and its associated factors in a specific Palestinian population.

## Key findings

- 29.0% of participants reported high diabetes distress, with emotional and regimen-related distress being most common.
- Comorbidities, smoking, and urban residence were significantly associated with higher distress levels.
- Younger age and non-urban residence were protective factors against high distress.

## Abstract

Diabetes distress, the emotional burden and stress related to managing type 2 diabetes mellitus, has been linked to poor self-management and adverse health outcomes. In Palestine, particularly in the North of West Bank, adults with type 2 diabetes mellitus face unique social and economic challenges that may exacerbate diabetes distress, impacting their ability to maintain effective diabetes management. Addressing diabetes distress is crucial for improving health outcomes and quality of life in this population, yet research on its prevalence and associated factors in the North of West Bank is limited. This study aimed to assess the prevalence of diabetes distress and identify its associated demographic, socioeconomic, and clinical factors among adults with type 2 diabetes mellitus in the North of West Bank, Palestine.

A cross-sectional study was conducted with 404 adults diagnosed with type 2 diabetes mellitus in various healthcare centers across the North of West Bank. Participants completed the Diabetes Distress Scale-17 and a sociodemographic questionnaire, and additional clinical data such as HbA1c levels. Descriptive and inferential statistics were employed to identify associations between diabetes distress and demographic, socioeconomic, and clinical factors, with a focus on assessing the impact of these variables on distress levels.

Of the 423 eligible individuals approached, 404 participants were included in the final analysis (response rate: 95.5%). The median age was 55 years (IQR: 49–63), with a nearly equal gender distribution. Poor glycemic control (HbA1c > 6.4%) was observed in 76.0% of participants, and 74.3% reported one or more comorbidities. High and moderate levels of diabetic distress were reported by 29.0% and 25.2% of participants, respectively, with emotional and regimen-related distress being the most prevalent domains. Significant factors associated with higher distress included comorbidities, smoking, urban residence, unemployment, living with family, and residence in Nablus. Multinomial logistic regression revealed that absence of comorbidities, younger age, living alone, and non-urban residence were protective factors against high distress (p < .05). The model explained 20.1% of the variance in distress levels (Nagelkerke R² = 0.201).

Diabetes distress is common among adults with type 2 diabetes and is significantly influenced by clinical, sociodemographic, and lifestyle factors. Routine screening and targeted psychosocial interventions are essential, especially for high-risk groups, to improve both psychological well-being and diabetes outcomes.