Estresse emocional relacionado à doença em pessoas com diabetes mellitus tipo 2

Abstract

Type 2 diabetes mellitus (DM2) is a complex metabolic disease with a heterogeneous etiology, with risk factors at the social, behavioral, environmental levels and strong genetic susceptibility. It is a chronic non-communicable disease whose prevalence has been increasing dramatically and Brazil is currently among the ten countries with the highest number of affected individuals. Living with this disease requires permanent care and this constant demand can generate anguish, discomfort, feelings that were called 'diabetes distress' and that in portuguese can be translated to 'emotional stress related to diabetes' or 'emotional suffering caused by diabetes '. It is about the emotional burden and specific concerns of the subject's experience who has to deal with this chronic disease. The objective of this research was to estimate the prevalence of this stress in people with DM2 in a population in the south of Minas de Gerais and to evaluate the possible related social and clinical factors. This is a cross-sectional study, which used a social and clinical questionnaire and the scale of emotional stress caused by diabetes (Brazilian Diabetes Distress Scale – B-DDS). Analysis of variance (ANOVA) was used to identify (at 5% significance level) which factors (social and clinical variables) influence DDS scores. Participated in the study 170 subjects, adults, whose mean age was 60.1 (±11.4) years, mean BMI of 29.2 (±6.3) kg/m2, mostly women (57.6%) . The mean duration of diabetes was 10.1 (±7.5) years, with a mean glycated hemoglobin (HbA1c) of 8,4% (69 mmol/mol) and the majority had complications and/or comorbidities (81.2% ). The prevalence of diabetes distress was 68% and the total DDS score was 2.45 (±0.64), corresponding to moderate emotional stress. All subareas also presented scores equivalent to moderate stress. Education was the variable that was related in almost all analyses: with the overall emotional stress score and in three of the four subareas. Emotional stress was higher in women, in subjects with less schooling and in those who had a recent change in medications for continuous use; being lower in those using sulfaniurea and in those undergoing multidisciplinary follow-up. Recognizing the existence of this suffering, as well as mapping according to the region is essential to understand the local reality and outline possible future interventions. Since Brazil is one of the countries with the highest number of people with diabetes in the world, it has a population with very large social and cultural diversity, further studies are needed to understand the real prevalence in our environment and its associated factors. This broader view will allow the treatment of the subject in its entirety, as a biopsychosocial being that everyone is, and can impact with improvement in self-care and better control of the disease.