Title:
Assessment of diabetic distress and disease related factors in patients with type 2 diabetes in Isfahan: A way to tailor an effective intervention planning in Isfahan-Iran.

Abstract:
The purpose of this study was to assess diabetes distress and its related factors among type 2 diabetic patients to better tailor intervention planning in Isfahan-Iran.
A cross-sectional study was conducted in 2011. Study population was patients with type 2 diabetes referring to Omolbanin, an outpatient diabetic center in Isfahan. 140 diabetic patients met the inclusion criteria and were all included in the study. Patient's diabetes distress was measured by DDS. A 17-item self-report diabetes distress scale was used with subscales reflecting 5 domains: 1) Emotional burden (5 items), 2) Physician distress (4 items), 3) Regimen distress (5 items) and 4) Interpersonal distress (3 items). The responses to each item were rated between 1 and 6 (1 = not a problem, 2 = a slight problem, 3 = a moderate problem, 4 = somewhat serious problem, 5 = a serious problem, 6 = a very serious problem). The minimum and the maximum of score in the scale were 17 and 114 respectively. Collected data was analyzed by using SPSS software version 11.5.
Mean age of participants were 53.23 years (SD = 7.82). 54.3% was female, 97.1% was married, and 57.1% had education lower than diploma. The average score of total diabetes distress was 2.96 ± 0.83. The average score of each domain was (3.40 ± 1.18), (2.57 ± 0.88), (2.97 ± 0.90), (2.76 ± 0.91) respectively. 'Emotional Burden' was considered as the most important domain in measuring diabetes distress. Total diabetes distress had significant association with age (p = 0.02), duration of diabetes (p<0.001), marital status, comorbidity, complications (p<0.001), and history of diabetes (p = 0.01). Pearson correlation coefficient revealed that diabetes distress of type 2 diabetic patients has a linear and direct relation with HbAlc (r = 0.63, p<0.001).
It seems some keywords have a main role in diabetes distress such as emotional support, communication with patient and physician, self-efficacy and social support. All of these points are achievable through empowerment approach in diabetes care plan.