# Assessment of Prevalence and Risk Factors of Diabetes Distress Among Patients With Type 2 Diabetes Mellitus in an Urban Area of Chengalpattu District, India: A Cross-Sectional Study

## TL;DR

This study found that nearly 36% of type 2 diabetes patients in an Indian urban area experience diabetes distress, a psychological burden linked to poor diabetes management.

## Contribution

The study provides new prevalence data and identifies specific risk factors for diabetes distress in an Indian urban population.

## Key findings

- 35.6% of T2DM patients experienced diabetes distress.
- Use of both insulin and oral hypoglycemic agents, diabetic foot ulcers, and lack of physical activity were significantly associated with distress.
- Diabetic retinopathy and cardiac comorbidities also correlated with higher distress levels.

## Abstract

Background and aim

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder associated with significant physical and psychological complications, including diabetes distress, which is the emotional burden of living with and managing diabetes, adversely affecting glycemic control. It includes emotional, regimen-related, interpersonal, and physician-related distress. The global prevalence varies widely, while Indian data remain limited and inconsistent. Factors such as fear of complications, treatment fatigue, inadequate support, and poor doctor-patient communication contribute to this condition, which often goes unrecognized. This study aims to estimate the prevalence of diabetes distress and determine its risk factors among T2DM patients residing in an urban area of the Chengalpattu district.

Methodology

A cross-sectional study was conducted among T2DM patients in Anakaputhur, an urban area of the Chengalpattu district, Tamil Nadu, India. A total of 297 people participated in the study. A pretested, structured questionnaire was used to collect socio-demographic details, diabetes history, complication history, economic history, and activities of self-care. The validated Type 2 Diabetes Distress Assessment System (T2DDAS) was used to screen for diabetes distress. Data analysis was performed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, NY, USA).

Results

The prevalence of diabetes distress among T2DM patients was 35.6%. Being on treatment with both oral hypoglycemic agents (OHA) and insulin, having a diabetic foot ulcer, and not having adequate physical activity were found to be significantly associated with diabetes distress. The history of diabetic retinopathy and cardiac comorbidities was also found to be significantly associated with diabetes distress.

Conclusion

It was found that 35.6% of patients with T2DM suffered from diabetes distress, indicating a significant, but mostly unrecognized, health problem. These findings suggest that the interrelated consequences of clinical, psychological, and social issues in diabetes management warrant routine screening as part of diabetes care services. Distress management should be incorporated into the National Program for Non-communicable Diseases (NP-NCD) to enable early identification and support, helping to improve treatment adherence and quality of life by strengthening community healthcare.