Comparison of Diabetes-Related Distress Between Insulin and Anti-Diabetic Medication Users in Adult Type 2 Diabetes

Purpose: To investigate factors related to distress in type 2 diabetes patients with poor glycemic control, comparing insulin-treated (observation group) and oral-treated (control group) patients. Methods: All participants were adults (aged 20 to 70 years) with a diagnosis of Type 2 DM for a minimum of one year, who were being treated with medication for diabetes, and had a HbA1c value greater than 8.5%. Both groups completed the following questionnaire surveys: Problem Areas in Diabetes (PAID), Insulin Treatment Appraisal Scale (ITAS), Hypoglycemia Fear Survey II (HFS II), and Demoralization Scale Mandarin Version (DS-MV).Results: Comparisons of insulin-treated patients (n = 35) with oral-treated patients (n = 34) showed that in patients with a PAID score >40, the insulin-treated group reported significantly higher distress than the oral-treated group. Patients treated with insulin had a higher negative attitude toward ITAS than those treated with oral therapy. Compared with oral-treated patients, the incidence of mild and moderate hypoglycemia was significantly higher in the insulin-treated patients. The insulin-treated patients (40.89 ± 6.43) had a significantly higher negative perception of demoralization syndrome than the oral-treated patients (26.88 ± 2.85).Conclusion: Compared with the oral-treated patients, insulin-treated patients reported significant distress associated with diabetes and held a more negative attitude, as these patients were particularly fearful of hypoglycemia, which has implications for their mental health. Healthcare providers should be mindful of distress in patients with type 2 diabetes receiving different treatment options during the course of the disease, especially when insulin treatment is required or complications occur.