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Type 2 diabetes and emotional well-being: results from the Australian National Diabetes Audit

An ANDA publication reports on the prevalence of depression and diabetes distress in adults with type 2 diabetes in Australia.

By Sienna Russell-Green [1]


Type 2 diabetes and depression often coincide. People with diabetes are more likely to have depression compared to those without diabetes. As depression has a significant impact on a person’s well-being and quality of life, it is crucial for it to be diagnosed and managed appropriately. In addition, depression has been shown to be associated with elevated HbA1c, and higher rates of complications and mortality. The impact depression has on diabetes may be explained by diabetes distress. Distinct from depression, diabetes distress [2] refers to the emotional distress related specifically to living with and managing diabetes, including feelings of frustration, worry and helplessness. Although studies [3] have demonstrated that both depression and diabetes distress are prevalent among adults with type 2 diabetes, there is limited data exploring their co-existence in Australian adults with type 2 diabetes.

In this study [4], data from the Australian National Diabetes Audit (ANDA) were analysed, including 2,552 adults with type 2 diabetes (mean age 63 ± 13 years) attending 50 diabetes centres nationwide. The Brief Case-Find for Depression (BCD), a screening tool for depressive symptoms, assessed likely depression. Diabetes distress was assessed using the 17-item Diabetes Distress Scale (DDS17).

The study found that approximately 1 in 3 adults with type 2 diabetes attending these clinics have likely depression and/or diabetes distress. Depression was more prevalent than diabetes distress (23% versus 7%), with 5% of individuals having both. Further analyses showed that those with likely depression had greater difficulties engaging in healthy eating and taking medication as recommended; they were also more likely to smoke. Severe diabetes distress was associated with female gender, elevated HbA1c, insulin use, difficulties in following recommendations for healthy eating, self-monitoring of blood glucose, and depression. Those who were younger were more likely to have mild diabetes distress.

These findings emphasise the importance of screening for and addressing mental health in adults with type 2 diabetes. Given the high prevalence of likely depression, and to a lesser extent diabetes distress, routine screening of this population should be encouraged to optimise mental and physical health and improve quality of life. However, the findings of the current study and previous research indicate that it is important to distinguish between diabetes distress and depression, as these are two distinct psychological states requiring different management strategies. 

The ACBRD has published reports on the psychological aspects of living with diabetes, including information on depression and diabetes distress. Click here [5] to find out more. You can also check out our recent blog posts about depression or diabetes distress here [6] and here [7].

Nanayakkara N, Pease A, Ranasinha S, Wischer N, Andrikopoulos S, Speight J [8], de Courten B & Zoungas S. Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA). Scientific Reports, 2018; 8: 7846. doi: 10.1038/s41598-018-26138-5