Prevalence of diabetes distress and its association with medication adherence and diabetes control among patients with type 2 diabetes mellitus in Egypt and Jordan

This study aimed to examine the prevalence of diabetes distress and explore its potential impact on medication adherence and diabetes control. This cross-sectional clinical study was conducted among outpatients with type 2 diabetes in selected hospitals in Egypt and Jordan. The validated tools, the Diabetes Distress Scale (DSS), Self-Efficacy for Appropriate Medication Use (SEAMS), and the Malaysia Medication Adherence Assessment Tool (MyMAAT), were used for data collection. Descriptive and inferential statistics were employed as appropriate. This study included 475 participants, 56% from Egypt and 44% from Jordan. Among participants, 77.5% faced complications, and 45% exhibited uncontrolled HbA1c levels – a total of 29% and 40% experienced moderate and severe distress, respectively. The findings reveal a median total DSS score of 2.29 (IQR 1.41) on a scale of 1–6, with variations across subscales. Regimen distress had the highest score at 2.40 (IQR 1.60), followed by physician-related distress at 2.25 (IQR 1.75) and emotional distress at 2.20 (IQR 2.00). The interpersonal subscale recorded the lowest score at 2.00 (IQR 1.67). Spearman’s rank correlation coefficient was employed to assess the relationship between diabetes distress and medication adherence. A significant negative correlation was observed (rs = −0.339, p < 0.001), indicating that higher levels of diabetes distress are associated with lower medication adherence. Our study explored the potential relationship between diabetes distress and HbA1c-based diabetes control. The Mann-Whitney U test (U = 20613, p = 0.004) revealed a significant difference in total Diabetes Distress Scale (DDS) scores between the two groups. The mean ranks indicate that DDS scores are notably higher in the uncontrolled group (206.97) compared to the controlled group (174.40). Diabetes-related distress appears to be widespread and is associated with various patient-related factors. This distress can significantly influence medication adherence and overall diabetes control. Strategies to enhance diabetes control should prioritise interventions that address key distress domains, particularly regimen and physician-related challenges.