Does Individuals with Type 2 Diabetes Mellitus Acceptance of Illness, Emotional Distress and Depression Affect The Nutritional Status and Quality of Life?
Abstract
Aim
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.
Methods
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.
Results:
The mean score of individuals’ AIS were 30.2±5.62. Compared to women, men had lower emotional distress and depression levels (p<0.05), higher physical, mental life quality (p<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<0.05).
Conclusions:
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.
Keywords:
Nutrition in type 2 diabetes mellitus, depression, emotional distress, acceptance of illness, quality of life
What’s known
• It is known that the presence of DM in an individual does not increase compliance with nutritional recommendations.
• 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.
What’s new
• 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.
• 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.
INTRODUCTION
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].
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].
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.
MATERIALS AND METHODS