Diabetes Distress and Illness Perceptions in Tunisian Type 2 Diabetes Patients

Figures & data

Table 1 Demographic and Clinical Characteristics of Tunisian Adult with DM 2 (N = 103)

Variable		N	Mean ± SD Median (Range)	%
Gender	Male	47		45.6
	Female	56		54.4
Age			59.1 ± 10.83
Marital status	Single	3		2.9
	Married	88		85.4
	Divorced	1		1
	Widower	11		10.7
Education level	Illiterate	19		18.4
	Primary	41		39.8
	Secondary	40		38.8
	University	3		2.9
Employment	Unemployed or Retired	61		59.2
	Employed	42		40.8
Economic income	High	1		1
	Medium	64		62.1
	Low	38		36.9
Age at diagnosis (year)			49,62 ± 9.4
Duration of DM (year)			7 (1–34)
Family history of DM	Yes	98		95.1
	No	5		4.9
Use of diet to manage the disease	Yes	51		49.5
	No	52		50.5
Use of physical exercise	Yes	44		42.7
	No	59		57.3
Diabetes treatment methods	Oral medication	82		79.6
	Insulin usage	48		46.6
Presence of comorbid illness	Yes	83		80.6
	No	20		19.4
Presence of diabetic complications	Yes	42		40.8
	No	61		59,2
HbA1C	<7	32		31.1
	≥7	71		68.9

Abbreviations: N, Number; SD; Standard Deviation; DM, Diabetes mellitus; HbA1C, hemoglobin A1C.

Figure 1 Distribution of respondents according to the level of diabetes distress (DD).

Table 2 Descriptive Statistics for the 8 Items of the Brief Illness Perception Questionnaire (the Brief IPQ) Completed by Patients with Diabetes Mellitus Type 2

Brief IPQ Items	Median	Range
Consequence	7	1–10
Timeline	10	1–10
Personal control	4	1–10
Treatment control	7	1–10
Identity	7	1–10
Concern	7	1–10
Coherence	6	2–9
Emotional response	7	1–10

Table 3 Demographic and Clinical Factors Associated with Diabetes Distress

		Patients with Distress N (%)	p-value
Gender	Male	35 (74.5%)	0.462
	Female	38 (67.9%)
Age	< 60 years	41 (77.4%)	0.136
	≥ 60 years	32 (64%)
Marital status	Married	66 (75%)	0.034*
	Single-Divorced –widower	7 (46.7%)
Economic income	Low	34 (89.5%)	0.001*
	Medium-high	39 (60%)
Education level	Illiterate - Primary	41 (68.3%)	0.503
	Secondary - University	32 (74.4%)
Employment	Employed	34 (81%)	0.062
	Unemployed or Retired	39 (63.9%)
Age at diagnosis	< 50 years	41 (87.2%)	0.001*
	≥ 50 years	32 (57.1%)
Duration of DM	< 10 years	40 (71.4%)	0.892
	≥ 10 years	33 (70.2%)
Comorbid illness	No	19 (95%)	0.008*
	Yes	54 (65.1%)
Use of diet	No	36 (69.2%)	0.711
	Yes	37 (72.5%)
Use of physical exercise	No	48 (72.7%)	0.58
	Yes	25 (67.6%)
Insulin	No	34 (61.8%)	0.030*
	Yes	39 (81.3%)
Oral medication	No	17 (81%)	0.255
	Yes	56 (68.3%)
Complications	No	43 (70.5%)	0.918
	Yes	30 (71.4%)
HbA1C	<7	14 (43.8%)	< 0.001*
	≥7	59 (83.1%)

Note: *p < 0.05.

Abbreviations: N, Number; DM, Diabetes mellitus; HbA1C, hemoglobin A1C.

Table 4 Results of the Nonparametric Test (Mann–Whitney U-Test) for the Association of Illness Perceptions Domains and Diabetes Distress

	No Distress	With DD	p-value
Consequence	5,03 ± 1.92	6,68 ± 1.83	< 0.001*
Timeline	9,53 ± 0.68	8,83 ± 1.78	0.07
Personal control	5,90 ± 1.97	4,42 ± 2.02	0.001*
Treatment control	7,96 ± 1.44	6,17 ± 1.96	< 0.001*
Identity	5,86 ± 1.79	6,50 ± 2.03	0.06
Concern	5,50 ± 1.61	6,94 ± 1.76	< 0.001*
Coherence	5,93 ± 1.68	5,35 ± 1.85	0.129
Emotional response	5,53 ± 1.83	7,15 ± 1.75	< 0.001*

Note: *p < 0.05.

Abbreviation: DD, Diabetes distress.

Table 5 Multivariate Logistic Regression Analysis of Factors Associated with DD

	Adjusted OR	95% CI	p-value
Personal control	0.62	0.45–0.86	0.004*
HbA1C	4.87	1.50–15.77	0.008*
Comorbid illness	0.063	0.005–0.87	0.039*
Age at diagnosis	0.93	0.87–0.99	0.027*
Socioeconomic status	0.07	0.01–0.38	0.002*

Note: *p < 0.05.

Abbreviations: DD, Diabetes distress; OR, Odds Ratio; CI, confidence interval; HbA1C, hemoglobin A1C.