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Introduction <p>Existing studies mostly focus on the separate impacts of diabetes distress, depression, and anxiety on glycemic control, leaving a gap in understanding their combined influence within primary care settings. This study aims to explore this interaction among patients with type 2 diabetes mellitus (T2DM) in Egyptian primary healthcare.</p> Methods <p>The study was conducted in rural primary healthcare settings in Egypt from September 2020 to June 2021, included 354 patients with T2DM. Sociodemographic, lifestyle, and clinical characteristics were assessed through patient interviews. Diabetes distress was measured using the 5-item Problem Areas in Diabetes Scale (PAID-5 scale), and symptoms of depression and anxiety were evaluated using the Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder 7 Scale (GAD-7), respectively. Glycated hemoglobin (HbA1c) measurements indicated glycemic control.</p> Results <p>Participants experienced varying mental health symptoms: 24.9% had one symptom, 8.2% had two, and 4.5% had all three (diabetes distress, depression, and anxiety symptoms). In multiple linear regression, not working status (β = −0.203, p = 0.015), dyslipidemia (β = 0.258, p = 0.021), increased BMI (β = 0.022, p &lt; 0.001), and more mental health symptoms (β = 0.267, p &lt; 0.001) predicted higher HbA1c levels. Ordinal regression found that higher educational levels (OR = 2.385, p = 0.021), sufficient income (OR = 2.360, p = 0.007), and higher HbA1c (OR = 3.103, p &lt; 0.001) predicted more mental health symptoms.</p> Conclusion <p>Mental health symptoms were common, and there were reciprocal associations between elevated HbA1c levels and increased mental health symptoms.</p>

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Combined symptoms of diabetes distress, depression, and anxiety and their association with glycemic control in primary care patients with type 2 diabetes in Egypt

  • 期刊论文

  • 发表日期：

    2025年1月27日

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  • Hazem A. Sayed Ahmed,
  • Samar F. Mohamed,
  • Anwar I. Joudeh,
  • Sally Fawzy Elotla,
  • Mona Mostafa,
  • Jaffer Shah,
  • Ahmed Mahmoud Fouad,
  • Samy Abdelrazek Abdelazim

摘要

Introduction

Existing studies mostly focus on the separate impacts of diabetes distress, depression, and anxiety on glycemic control, leaving a gap in understanding their combined influence within primary care settings. This study aims to explore this interaction among patients with type 2 diabetes mellitus (T2DM) in Egyptian primary healthcare.

Methods

The study was conducted in rural primary healthcare settings in Egypt from September 2020 to June 2021, included 354 patients with T2DM. Sociodemographic, lifestyle, and clinical characteristics were assessed through patient interviews. Diabetes distress was measured using the 5-item Problem Areas in Diabetes Scale (PAID-5 scale), and symptoms of depression and anxiety were evaluated using the Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder 7 Scale (GAD-7), respectively. Glycated hemoglobin (HbA1c) measurements indicated glycemic control.

Results

Participants experienced varying mental health symptoms: 24.9% had one symptom, 8.2% had two, and 4.5% had all three (diabetes distress, depression, and anxiety symptoms). In multiple linear regression, not working status (β = −0.203, p = 0.015), dyslipidemia (β = 0.258, p = 0.021), increased BMI (β = 0.022, p < 0.001), and more mental health symptoms (β = 0.267, p < 0.001) predicted higher HbA1c levels. Ordinal regression found that higher educational levels (OR = 2.385, p = 0.021), sufficient income (OR = 2.360, p = 0.007), and higher HbA1c (OR = 3.103, p < 0.001) predicted more mental health symptoms.

Conclusion

Mental health symptoms were common, and there were reciprocal associations between elevated HbA1c levels and increased mental health symptoms.