ĐÁNH GIÁ CĂNG THẲNG LIÊN QUAN ĐÁI THÁO ĐƯỜNG VÀ CÁC YẾU TỐ LIÊN QUAN TRÊN BỆNH NHÂN ĐÁI THÁO ĐƯỜNG TÍP 2 CAO TUỔI

Abstract

Objectives: To assess the incidence of moderate - severe stress and related factors of diabetes related – distress in elderly patients with type 2 diabetes. Methods: This cross-sectional study was conducted on 161 outpatients aged ≥ 60 years with type 2 diabetes mellitus for 3 months or more at the Endocrinology Clinic of Thong Nhat Hospital in Ho Chi Minh City from October 2023 to the end of November 2023. Subjects were given results from interviews using the Diabetes Distress Scale (DDS-17) and related factors. Results: Older adults with moderate - severe diabetes stress were less likely to have highest levels of education below high school (35% vs 5%, p <0.001), less than 5 years of illness were more likely to experience severe stress (31.8% vs 13.8%, p<0.001) and >10 years were at risk of moderate stress (73.2% vs 45.5%, p<0.001). In addition, patients taking oral medications, poor medication adherence and poor glycemic control increased their likelihood of stress (p<0.05). On the geriatric front, stress was less common in patients who were not impaired (79% vs 17%, p<0.001), took no more than five types of medication per day, and had no or mild geriatric depression (p<0.05). In multivariate logistic regression model, stress-related factors in elderly patients with type 2 diabetes mellitus are hypertension (OR 0.16; 95% CI 0.03 – 0.99; p <0.05), diabetic retinopathy (OR 269.74; 95% CI 7.71 – 9431.64; p <0.05), treatment modalities (OR 4.60; 95% CI 1.46 – 14.89; p <0.05), medication adherence (OR 3.63; 95% CI 1.30 – 10.16; p <0.05), the degree of glycemic control (OR 1.28; 95% CI 0.34 – 4.79; p <0.05) and geriatric depression (OR 16.76; 95% CI 0.00 – 1544.85; p <0.05). Conclusions: Duration of diabetes, method of treatment, diabetes-related comorbidities, medication adherence and glycemic control, multi-drugs, and geriatric depression are factors that increase stress risk in older adults. Diabetes – related distress is an issue that needs to be screened and evaluated in the health care of the elderly and is also a strategic goal in protecting mental health as recommendation of ADA 2024¹.