Emotional Distress and Metabolic Control in Diabetic Patients Attending Primary Health Care in the Eastern Province, Saudi Arabia

Abstract

Background: Recognition and treatment of emotional distress, which affects 20 to 40% of outpatients with type 1 or type 2 diabetes, are important because of its association with worse diabetes self-care, poor glycemic control, increased rates of mortality and diabetes-related complications, and a rise in healthcare expenditure. However, although the symptoms of emotional distress improve in diabetic patients after psychological and pharmacological interventions, evidence of benefits in glycemic control is still uncertain. Objective: The aim of this study was to assess the metabolic control in diabetic patients with emotional distress attending primary mental care clinics (PMCC) in the Eastern Province of Saudi Arabia. Method: This study was a single group pretest-posttest design conducted on adult diabetic patients with emotional distress attending PMCC. Out of 194 attendees, 62 patients who fulfilled the selection criteria were studied. Data were collected from the patients’ records using a worksheet designed for the study. Metabolic parameters including BMI, BP, FBS, HbA1c and lipid profile were recorded before and after the management of emotional distress. Socio-demographic characteristics, complications related to diabetes and co-morbidities were also recorded. Paired t-test was used appropriately to compare continuous variables. A p-value of less than 0.05 was considered significant in all statistical analysis. Results: The majority of the patients had type 2 DM (98.2%) and the presence of co-morbidities was high (83.9%). A comparison of the metabolic parameters before and after management of emotional distress, showed a significant reduction in HbA1c (p = 0.020) and elevation in HDL (p = 0.010). No differences in BMI, BP, FBS, TC, TG or LDL were found. Conclusions: Treating emotional distress in diabetic patients is associated with an improvement in HbA1c and HDL.