Psychological distress, coping methods and self-care among people with diabetes mellitus in Ibadan.
Main Article Content
Keywords
Diabetes mellitus, coping, psychological distress, diabetes self-care
Abstract
Background: Diabetes mellitus (DM) is a chronic metabolic disorder associated with serious complications if poorly controlled. Beyond routine clinical follow-up, people with diabetes (PWD) are required to engage in sustained self-care activities. Fear of complications and the demands of self-management may lead to psychological distress, which can negatively influence coping strategies and adherence to self-care practices. The study aims to determine the level of psychological distress among people with diabetes mellitus and to assess its relationship with coping styles and diabetes self-care activities.
Methodology: This descriptive cross-sectional study was conducted among PWD attending the Medical Outpatients’ Clinic of the University College Hospital, Ibadan. Two hundred participants completed a structured questionnaire comprising the Diabetes Distress Scale (DDS), a modified Brief Coping Orientation to Problems Experienced (Brief-COPE), and the Summary of Diabetes Self-Care Activities (SDSCA). Ethical approval was obtained from the institutional review board (UI/EC/24/0064; 21 February 2024). Data were analysed using SPSS version 26, employing descriptive statistics, independent t-tests, and chi-square tests, with statistical significance set at p< 0.05.
Results: The mean age of respondents was 57.54 ± 10.87 years, with females constituting 51% of participants. Approximately 64% had attained tertiary education. High psychological distress was observed in 38% of respondents. The most commonly reported coping strategies were problem-focused approaches, including taking actions to improve situations and reframing diabetes positively, as well as seeking emotional support. High psychological distress was significantly associated with the use of avoidant coping strategies (p< 0.001). A significant association was also found between psychological distress and poor diabetes self-care practices (p = 0.041).
Conclusion: Psychological distress is common among people with diabetes and adversely affects coping mechanisms and self-care activities. Integrating routine psychological screening and promoting positive coping strategies within diabetes self-management education may improve overall patient outcomes.
References
Wade AN, Maposa I, Agongo G, Asiki G, Boua P, Choma SSR, et al. Diabetes care cascade and associated factors in 10 700 middle-aged adults in four sub-Saharan African countries: a cross-sectional study. BMJ Open. 2023 Apr 27;13(4).
Olamoyegun MA, Alare K, Afolabi SA, Aderinto N, Adeyemi T. A systematic review and meta-analysis of the prevalence and risk factors of type 2 diabetes mellitus in Nigeria. Clin Diabetes Endocrinol. 2024 Dec 6;10(1).
Hapunda G. Coping strategies and their association with diabetes specific distress, depression and diabetes self-care among people living with diabetes in Zambia. BMC Endocr Disord. 2022 Dec 1;22(1).
Blangeti GK, Chima T, Kamanga CN, Mkwinda E. Prevalence and Associated Factors of Psychological Distress Among Diabetic Patients at Thyolo District Hospital in Malawi: A Hospital-Based Cross-Sectional Study. Diabetes, Metabolic Syndrome and Obesity. 2024;17:893–900.
Akhaury K, Chaware S. Relation Between Diabetes and Psychiatric Disorders. Cureus. 2022 Oct 27;14(10):e30733.
Polonsky WH, Fisher L, Hessler DM, Desai U, King SB. Toward a more comprehensive understanding of the emotional side of type 2 diabetes: A re-envisioning of the assessment of diabetes distress. J Diabetes Complications [Internet]. 2022 Jan [cited 2025 Nov 1];36(1). Available from: [https://www.sciencedirect.com/science/article/abs/pii/S1056872721003275](https://www.sciencedirect.com/science/article/abs/pii/S1056872721003275).
Poongothai S, Anjana RM, Radha S, Sundari BB, Rani CSS, Mohan V. Epidemiology of Depression and Its Relationship to Diabetes in India. J Assoc Physicians India [Internet]. 2017 [cited 2025 Nov 8];65(8):60–6. Available from: [https://pubmed.ncbi.nlm.nih.gov/28799308/](https://pubmed.ncbi.nlm.nih.gov/28799308/).
Huang H, Wei WX, Huang T, Wang F, Zhang HT. Prevalence and associated factors of depressive symptoms among older adult diabetic patients in China: a nationally representative cross-sectional study. Front Psychol. 2025;16.
Kamrul-Hasan ABM, Pappachan JM, Nagendra L, Muthukuda D, Dutta D, Bhattacharya S, et al. Prevalence of diabetes distress among people with type 2 diabetes in South Asia: A systematic review and meta-analysis. World J Diabetes. 2025 Aug 15;16(8).
Sayed Ahmed HA, Fouad AM, Elotla SF, Joudeh AI, Mostafa M, Shah A, et al. Prevalence and Associated Factors of Diabetes Distress, Depression and Anxiety Among Primary Care Patients With Type 2 Diabetes During the COVID-19 Pandemic in Egypt: A Cross-Sectional Study. Front Psychiatry. 2022 Jun 3;13.
Batais MA, Alfraiji AF, Alyahya AA, Aloofi OA, Almashouq MK, Alshehri KS, et al. Assessing the Prevalence of Diabetes Distress and Determining Its Psychosocial Predictors Among Saudi Adults with Type 2 Diabetes: A Cross-Sectional Study. Front Psychol. 2021 Dec 22;12.
Perrin NE, Davies MJ, Robertson N, Snoek FJ, Khunti K. The prevalence of diabetes-specific emotional distress in people with Type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2017;34:1508–20.
Gupta J, Khandelwal D, Gupta L, Dutta D, Mittal S, Khandelwal R, et al. Occurrence and Predictors of Diabetes Distress in Adult Patients with Type 2 Diabetes from North India. Indian J Endocrinol Metab. 2025 Mar 1;29(2):202–8.
Gupta SK, Rastogi A, Kaur M, Lakshmi PVM. Diabetes-related distress and its impact on self-care of diabetes among people with type 2 diabetes mellitus living in a resource-limited setting: A community-based cross-sectional study. Diabetes Res Clin Pract [Internet]. 2022 Sep [cited 2025 Nov 1];191. Available from: [https://www.sciencedirect.com/science/article/abs/pii/S0168822722008841](https://www.sciencedirect.com/science/article/abs/pii/S0168822722008841).
Hoogendoorn CJ, Schechter CB, Llabre MM, Walker EA, Gonzalez JS. Distress and Type 2 Diabetes Self-Care: Putting the Pieces Together. Ann Behav Med. 2021 Oct 1;55(10):938–48.
Kintzoglanakis K, Gkousiou A, Vonta P, Sagmatopoulos A, Copanitsanou P. Depression, anxiety, and diabetes-related distress in type 2 diabetes in primary care in Greece: Different roles for glycemic control and self-care. SAGE Open Med. 2022;10.
Wojujutari Ajele K, Sunday Idemudia E. The role of depression and diabetes distress in glycemic control: A meta-analysis. Diabetes Res Clin Pract. 2025;221. DOI 10.7759/cureus.30733.
Embaye J, Snoek FJ, de Wit M. Coping strategies for managing diabetes distress in adults with type 1 and type 2 diabetes: a cross-sectional study on use and perceived usefulness. Front Clin Diabetes Healthc. 2024;5.
Verma M, Sidana S, Kumar P, Singh O, Esht V, Balasubramanian K, et al. Distress and coping mechanisms among people with diabetes: cross-sectional assessment from an NCD screening clinic of a tertiary care hospital in North India. Diabetol Metab Syndr. 2025 Dec 1;17(1).
Onyenekwe BM, Young EE, Nwatu CB, Okafor CI, Ugwueze CV. Diabetes Distress and Associated Factors in Patients with Diabetes Mellitus in Southeast Nigeria. Dubai Diabetes Endocrinol. 2020 Aug 31;26(1):31–7.
Joseph JG, Olagunju AV, Bulus I, Ishaku S, Toroh LI, Ephraim OD. Coping mechanisms among patients with diabetes mellitus (type 1 & 2) in University College Hospital, Ibadan, Nigeria. J Public Health Dis. 2021 Feb 28;4(1):11–9.
Onwuchuluba EE, Aina BA, Ngolube CP, Ogbonna BO. Diabetes-related Distress and Self-care Practices among Patients attending two Secondary Care Hospitals in Lagos: A strategy for tailored Interventions. J Basic Soc Pharm Res. 2019;1(1):22–9.
Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care. 2000;23(7):943–950.
Ketema DB, Leshargie CT, Kibret GD, Assemie MA, Alamneh AA, Kassa GM, et al. Level of self-care practice among diabetic patients in Ethiopia: A systematic review and meta-analysis. BMC Public Health. 2020 Mar 12;20(1).
Chittooru CS, Gorantla AK, Panati DD, Chaudhuri S, Prahalad H. Self-care practices and its determinants among diabetic population in rural Andhra Pradesh, India: A cross-sectional study. Clin Epidemiol Glob Health. 2022 Jul 1;16.
Woodward A, Walters K, Davies N, Nimmons D, Protheroe J, Chew-Graham CA, et al. Barriers and facilitators of self-management of diabetes amongst people experiencing socioeconomic deprivation: A systematic review and qualitative synthesis. Health Expect. 2024;27:e14070.
Abd El Kader AI, Ibrahim ME, Mohamed HS, Osman BM. Diabetes Distress and Self-Care Activities Among Patients with Diabetes Type II: A Correlation Study. SAGE Open Nurs. 2023 Jan 1;9.
Akbari F, Molavynejad S, Rokhafroz D, Nia HS. Effect of Diabetes Distress and Self-care Activities on the Quality of Life of Type 2 Diabetic Patients: A Structural Equation Model. Jundishapur J Chronic Dis Care. 2022 Jan 1;11(1).
Zhang YY, Li W, Sheng Y, Wang Q, Zhao F, Wei Y. Prevalence and Correlators of Diabetes Distress in Adults with Type 2 Diabetes: A Cross-Sectional Study. Patient Prefer Adherence. 2024;18:111–30.
Lau CYK, Kong APS, Joseph TF, Chan V, Mo PKH. Coping skills and glycaemic control: the mediating role of diabetes distress. Acta Diabetol. 2021 Mar;58:1071–9.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.