<div>Does Individuals with Type 2 Diabetes Mellitus Acceptance of Illness,
Emotional Distress and Depression Affect The Nutritional Status and
Quality of Life?</div><div>Abstract</div><div>Aim</div><div>The aim of the study was to determine the affect of individuals with
type 2 diabetes mellitus (DM) acceptance of illness, emotional distress,
depression on nutritional status, life quality.</div><div>Methods</div><div>This study was conducted in 145 type 2 DM, 73 males and 72 females,
ranging in age from 20-65 years. The Acceptance of Illness Scale (AIS)
for the determination of individuals’ acceptance of the illness, Problem
Areas in Diabetes (PAID) Scale for emotional distress, Beck Depression
Scale (BDS) for depression, Short Form-36 (SF-36) scales for quality of
life and Healthy Eating Index-2010 (HEI-2010) for diet quality was used.</div><div>Results:</div><div>The mean score of individuals’ AIS were 30.2±5.62. Compared to women,
men had lower emotional distress and depression levels
(p&lt;0.05), higher physical, mental life quality
(p&lt;0.001). The mean score of individuals’ HEI-2010 were
54.8±12.85 and more than half of the individuals had diet quality
required to be improved. Models that were emotional distress and SF-36
Mental Component Summary (MCS) with acceptance of illness (F(2,
142)=58.404); AIS, BDS and age (years) with emotional distress (F(3,
141)=53.174); emotional distress and SF-36 MCS with depression status
(F(2, 142)=82.029); acceptance of illness and depression status with
SF-36 MCS (F(2, 142)=70.937); emotional distress and depression status
with SF-36, Physical Component Summary (PCS) (F(2, 142)=42.926) were
statistically significant (p=0.000). Also, correlations among AIS, PAID
Scale, BDS, SF-36 were found to be significant (p&lt;0.05).</div><div>Conclusions:</div><div>The presence of diabetes does not require to have different nutritional
habit on individuals without diabetes. Although the diet quality of
individuals with type 2 DM is not primarily related to the individual’s
acceptance of the illness, emotional distress, depression status and
quality of life, the status of medical nutrition as a part of medical
treatment by the individual is one of the important criteria in
determining the priorities in diabetes management.</div><div>Keywords:</div><div>Nutrition in type 2 diabetes mellitus, depression, emotional distress,
acceptance of illness, quality of life</div><div>What’s known</div><div>• It is known that the presence of DM in an individual does not increase
compliance with nutritional recommendations.</div><div>• There are some obstacles (such as the duration of diabetes, lack of
nutritional education, insufficient social support, inability to make a
choice while eating out, acceptance of diabetes, diabetes distress and
depression) that prevent people with diabetes from adhering to the
recommended diet or medical nutritional treatment.</div><div>What’s new</div><div>• Correlations between AIS, PAID Scale, BDS and SF-36 were found to be
significant, but there was no correlation between the HEI-2010 and these
scales.</div><div>• It was found that the acceptance of the illness, emotional distress
about DM, depression and quality of life of individuals with type 2 DM
may affect each other, but the changes in these factors cannot affect
the diet quality of the individual with type 2 DM.</div><div>INTRODUCTION</div><div>Type 2 diabetes mellitus (DM), which is the most common type of DM,
accounts for approximately 90-95% of all diabetes cases [1].
According to the recent estimations of International Diabetes Federation
(IDF), in 2019, 1 (463 million) in every 11 adults (20-79 years old) has
diabetes, and it is estimated that case will be 700 million in 2045
[2]. Considering the worldwide cost of diabetes, nutritional
therapy, one of the lifestyle changes that has an important place in
preventing and managing type 2 DM, is at the key point [3]. The
goals of nutritional therapy in adults with diabetes include promoting
and supporting healthy eating habits, providing nutrient diversity in
appropriate portions, improving overall health, achieving and
maintaining body weight goals, achieving personalized glycemic, blood
pressure and lipid goals, delaying or preventing complications [4].</div><div>Nutritional therapy can reduce HbA1c by 1.0-2.0% and provide better
results in clinical and metabolic markers when combined with other
diabetes care [5]. However, studies have shown that approximately
half or more than half of individuals with diabetes do not adapt to
their diets [6, 7, 8]. There are some obstacles that prevent people
with diabetes from adhering to the recommended diet or medical
nutritional treatment. Among these obstacles, there are factors such as
the duration of diabetes, lack of nutritional education, insufficient
social support, and inability to make a choice while eating out [7,
8]. Also, it has been shown in different studies that acceptance of
diabetes, diabetes distress and depression in individuals with type 2 DM
are factors that can affect the nutrition of individuals [9, 10,
11]. It is known that, diet can also affect the quality of life in
individuals with diabetes [12]. Also, in a study, it is reported
that the attitude of individuals to diabetes does not guarantee
compliance with dietary recommendations alone, so other related factors
that affect the diet of an individual with diabetes should also be taken
into account [9]. Determining if individuals with type 2 diabetes
have obstacles in adapting to the nutritional plan, then creating
interventions to overcome these obstacles and ensuring changes can
support compliance with the nutritional plan [13].</div><div>For this reason, this study was conducted to determine the effects of
type 2 DM induvidials’ acceptance of illness, emotional distress and
depression on their nutritional status and quality of life, and it was
aimed to develop suggestions that facilitate diabetes management in the
diet and quality of life of individuals with diabetes.</div><div>MATERIALS AND METHODS</div>