Correlation Between Hba1c Levels, Emotional Stress And Dm Distress In Type 2 Diabetes Mellitus Patients
DOI:
https://doi.org/10.51601/ijhp.v5i4.376Abstract
This study aimed to examine the correlation between HbA1c levels, emotional distress, and diabetes-related distress (DM distress) among patients with type 2 diabetes mellitus (T2DM). Poor diabetes control and life stressors often lead to increased emotional and DM distress, which may elevate blood glucose through activation of the hypothalamic–pituitary–adrenal (HPA) axis. An analytical observational method with a cross-sectional design was used. Participants were outpatients with T2DM at PKU Muhammadiyah Gamping Hospital, selected using purposive sampling based on inclusion and exclusion criteria. HbA1c levels were analyzed using the boronate affinity method. Emotional distress was measured using the Depression Anxiety Stress Scale (DASS-42), and DM distress was assessed using the Diabetes Distress Scale (DDS-17). Statistical analysis employed the Shapiro–Wilk test for normality and the Spearman correlation test, with a significance level of α = 0.05. A total of 45 subjects participated (23 males and 22 females). The mean HbA1c level was 9.2 ± 2.6%, the mean emotional distress score was 80.2 ± 19, and the mean DM distress score was 2.49 ± 0.93. The results revealed significant positive correlations between HbA1c levels and emotional distress (r = 0.46, p = 0.001), HbA1c levels and DM distress (r = 0.52, p = 0.000), and between emotional distress and DM distress (r = 0.62, p = 0.000). These findings indicate that higher emotional and DM distress are associated with poorer glycemic control. Integrating psychosocial evaluation and emotional support into diabetes care is essential to improve metabolic and psychological outcomes in T2DM patients.
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Adam, L., Tomayahu, M.B., 2019. Tingkat Stres Dengan Kadar Gula Darah Pada Pasien Diabetes Melitus. JHSJ 1, 1–5. https://doi.org/10.37311/jhsj.v1i1.2047
Almutairi, J.S., Almigbal, T.H., Alruhaim, H.Y., Mujammami, M.H., AlMogbel, T.A., Alshahrani, A.M., Al Zahrani, A.M., Batais, M.A., Shaik, S.A., 2022. Self-awareness of HbA1c and its association with glycemic control among patients with type 2 diabetes: A multicenter study. SMJ 43, 291–300. https://doi.org/10.15537/smj.2022.43.3.20210536
American Diabetes Association, 2020. Standards of Medical Care in Diabetes—2020 Abridged for Primary Care Providers. Clinical Diabetes 38, 10–38. https://doi.org/10.2337/cd20-as01
Amir, F., Mastutik, G., Hasinuddin, M., Putra, S.T., 2018. Dhikr (recitation) and relaxation improve stress perception and reduce blood cortisol level in type 2 diabetes mellitus patients with ADM 54.
Amran, P., Rahman, R., 2018. Gambaran Hasil Pemeriksaan HbA1c Pada Penderita Diabetes Melitus Tipe II Di RSUD Labuang Baji Makassar. MAK 9. https://doi.org/10.32382/mak.v9i2.686
Batais, M.A., Alfraiji, A.F., Alyahya, A.A., Aloofi, O.A., Almashouq, M.K., Alshehri, K.S., Almizel, A.M., Alotaibi, M.T., Alosaimi, F.D., 2021. Assessing the Prevalence of Diabetes Distress and Determining Its Psychosocial Predictors Among Saudi Adults With Type 2 Diabetes: A Cross-Sectional Study. Front. Psychol. 12, 759454. https://doi.org/10.3389/fpsyg.2021.759454
Bener, A., Ozturk, M., Yildirim, E., 2017. Association between Depression, Anxiety and Stress Symptoms and Glycemic Control in Diabetes Mellitus Patients 1.
Bijayanti, I.A.N.P., Primatanti, P.A., Ningrum, R.K., 2021. Emosi Negatif pada Pasien Diabetes Melitus di Puskesmas IV Denpasar Selatan. e-Journal AMJ (Aesculapius Medical Journal) 2, 150–154.
Derek, M.I., Rottie, J.V., Kallo, V., 2017. Hubungan Tingkat Stres Dengan Kadar Gula Darah Pada Pasien Diabetes Melitus Tipe II Di Rumah Sakit Pancaran Kasih GMIM Manado 5.
Ebrahem, S.M., Masry, S.E., 2017. Effect of Relaxation Therapy on Depression, Anxiety, Stress and Quality of Life Among Diabetic Patients. CNS 5, 35. https://doi.org/10.5430/cns.v5n1p35
Fatih, H.A., Tania, M., Aprillia, D., 2023. Hubungan Tingkat Stres Dengan Kadar Gula Darah Penderita Diabetes Mellitus Di Kota Bandung 11.
Fayed, A., AlRadini, F., Alzuhairi, R.M., Aljuhani, A.E., Alrashid, H.R., Alwazae, M.M., Alghamdi, N.R., 2022. Relation between diabetes related distress and glycemic control: The mediating effect of adherence to treatment. Primary Care Diabetes 16, 293–300. https://doi.org/10.1016/j.pcd.2021.12.004
Fisher, L., Polonsky, W.H., Hessler, D., 2019. Addressing diabetes distress in clinical care: a practical guide. Diabet. Med. 36, 803–812. https://doi.org/10.1111/dme.13967
Fitri, A., Jafar, N., Indriasari, R., Syam, A., Salam, A., 2021. Hubungan Tingkat Stress Dengan Kadar Gula Darah Pada Polisi Yang Mengalami Gizi Lebih Di Polresta Sidenreng Rappang 10.
Hendrieckx, C., Halliday, J., Speight, J., 2019. Diabetes and emotional health A practical guide for healthcare professionals supporting adults with Type 1 and Type 2 diabetes, 2nd ed. Diabetes UK.
Hessler, D., Strycker, L., Fisher, L., 2021. Reductions in Management Distress Following a Randomized Distress Intervention Are Associated With Improved Diabetes Behavioral and Glycemic Outcomes Over Time. Diabetes Care 44, 1472–1479. https://doi.org/10.2337/dc20-2724
Ingrosso, D.M.F., Primavera, M., Samvelyan, S., Tagi, V.M., Chiarelli, F., 2023. Stress and Diabetes Mellitus: Pathogenetic Mechanisms and Clinical Outcome. Horm Res Paediatr 96, 34–43. https://doi.org/10.1159/000522431
Irfan, M., Wibowo, H., 2015. Hubungan Tingkat Stres Dengan Kadar Guladarah Pada Penderita Diabetes Mellitus (DM) Dipuskesmas Peterongan Kabupaten Jombang. Jurnal Ilmiah Keperawatan 1.
Jayakrishnan, Sreeja, JayanthiBai, 2019. Glycated Hemoglobin (HbA1c) - A Predictor of Glycemic Control and Diabetes Mellitus. International Journal of Health Sciences & Research 9, 7–11.
Laili, F., 2019. Hubungan Faktor Lama Menderita DM dan Tingkat Pengetahuan dengan Distres Diabetes pada Penderita Diabetes Mellitus Tipe 2 Tahun 2017 (Studi di Wilayah Kerja Puskesmas Rowosari, Kota Semarang). MKMI 18, 35–38. https://doi.org/10.14710/mkmi.18.2.35-38
Lenggogeni, D.P., Gusty, R.P., Erwanto, R.P., 2023. Implementasi Terapi Progressive Muscle Relaxation (PMR) Untuk Menurunkan Kadar Glukosa Darah Dan Stres Pada Pasien Diabetes Mellitus Tipe 2. REAL in Nursing Journal (RNJ 6, 205–2012.
Livana Ph, Sari, I.P., Hermanto, H., 2018. Gambaran Tingkat Stres Pasien Diabetes Mellitus. Jurnal Perawat Indonesia 2, 41. https://doi.org/10.32584/jpi.v2i1.40
Maswiyah, Gea, N.Y.K., Meliyana, E., 2023. Hubungan Tingkat Stress Dengan Kadar Gula Darah Orang Tua Muda Penderita Diabetes Mellitus Di RT 007 RW 001 Desa Jayalaksana Kecamatan Cabangbungin Kabupaten Bekasi 5.
Na, I., Hm, A., Cg, K., 2019. Study of the effect of glycemic control on the diabetes- related distress in a sample of Egyptian patients with diabetes mellitus. Jurnal Diabetes Updates 4.
Ningsih, N., Thahura, F., 2022. Kesehatan Mental Pasien Diabetes Melitus di Puskesmas Langsa Baro. Jurnal Kebidanan, Keperawatan Dan Kesehatan (Bikes) 2, 7–14. https://doi.org/10.51849/j-bikes.v2i1.20
Nurmaguphita, D., Sugiyanto, S., 2019. GAMBARAN DISTRESS PADA PENDERITA DIABETES MELLITUS. Jkj 6, 76. https://doi.org/10.26714/jkj.6.2.2018.76-82
Parsa, S., Aghamohammadi, M., Abazari, M., 2019. Diabetes Distress and Its Clinical Determinants in Patients with Type II Diabetes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 13, 1275–1279. https://doi.org/10.1016/j.dsx.2019.02.007
Sarihati, I.G.A.D., Karimah, H.N., Habibah, N., 2019. Gambaran Kadar HbA1c Pada Pasien Diabetes Melitus Tipe 2 Di RSUD Wangaya. M 6, 88–98. https://doi.org/10.33992/m.v6i2.442
Sidhu, R., Tang, T.S., 2017. Diabetes Distress and Depression in South Asian Canadians with Type 2 Diabetes. Canadian Journal of Diabetes 41, 69–72. https://doi.org/10.1016/j.jcjd.2016.07.008
Soudagar, S., Rambod, M., 2018. Prevalence of Stress, Anxiety and Depression and Their Associations with Spiritual Well-being in Patients with Diabetes. Sadra Med Sci J 6, 1–10.
Tareen, R.S., Tareen, K., 2017. Psychosocial aspects of diabetes management: dilemma of diabetes distress. Transl. Pediatr 6, 383–396. https://doi.org/10.21037/tp.2017.10.04
Thau, L., Gandhi, J., Sharma, S., 2023. Physiology, Cortisol. StatPearls Publishing LLC, Bradenton, Florida.
Virtanen, M., Ferrie, J.E., Tabak, A.G., Akbaraly, T.N., Vahtera, J., Singh-Manoux, A., Kivimäki, M., 2014. Psychological Distress and Incidence of Type 2 Diabetes in High-Risk and Low-Risk Populations: The Whitehall II Cohort Study. Dia Care 37, 2091–2097. https://doi.org/10.2337/dc13-2725
Wibowo, Z.K., Wibisono, S., Khairina, 2022. The relationship between diabetes distress and HbA1C level in type 2 diabetes mellitus therapy patients: a systematic review.
Wulandari, I.A.T., Herawati, S., Wande, I.N., 2020. Gambaran Kadar HbA1c Pada Pasien Diabetes Melitus Tipe II Di RSUP Sanglah Periode Juli-Desember 2017 9, 71–75.
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