Large-Scale Cross-Sectional Study of the Problem Areas in Diabetes Survey among Japanese Patients with Type 2 Diabetes Mellitus
Authors: TAKAHASHI KENICHIRO , SHINODA MINORI , SAKAMOTO RIKA , SUZUKI JUN , YAMAKAWA TADASHI , TERAUCHI YASUO 
Published: June 2018

Introduction: Diabetes treatment has unique aspects that require behavior modification among patients in terms of food consumption, exercise and others. The emotional burden among patients that is caused by diabetes treatment and diabetes-related morbidity in itself often causes patients to have trouble carrying out daily activities and makes the maintenance of glycemic control difficult. The aim of this study was to investigate the association between glycemic control and the Problem Areas in Diabetes (PAID) scores which is an indicator of emotional burden among Japanese patients with type 2 diabetes mellitus (T2DM) on a large scale.
Methods: Data from 3511 patients with T2DM were obtained from the Diabetes Registry in Kanagawa. We used PAID scores to evaluate diabetes-related emotional distress. For 3432 patients who answered completely, we assessed the association between PAID scores and HbA1c and other background factors, while adjusting for possible confounding factors.
Results: The mean age, body mass index, disease duration and HbA1c level were 63.2 years, 25.3 kg/m2, 12.5 years, and 7.53%, respectively. The mean PAID score was 43.3 points. Five point five percent were severely burdened patients who scored more than 70 points. There was a significant correlation between PAID scores and HbA1c (ρ=0.025, p&lt;0.001), and higher HbA1c levels were associated with higher PAID scores. Sex (female; p&lt;0.0001), younger age (p&lt;0.0001), higher BMI (p&lt;0.0001), diabetic neuropathy (p&lt;0.0001), diabetic retinopathy (p&lt;0.0001), and diabetic foot (p&lt;0.0037) were all associated with higher PAID scores. In the multiple regression analysis, HbA1c level (p&lt;0.0001), diabetic retinopathy (p=0.003) and injection therapy (p=0.0001) were independent factors affecting PAID scores.
Conclusions: Treatment to maintain normal levels of HbA1c may prevent the onset of diabetic retinopathy; moreover, it will reduce the emotional burden among patients with diabetes.

Disclosure
K. Takahashi: None. M. Shinoda: None. R. Sakamoto: None. J. Suzuki: None. T. Yamakawa: None. Y. Terauchi: Research Support; Self; MSD K.K.. Speaker's Bureau; Self; MSD K.K.. Advisory Panel; Self; MSD K.K.. Research Support; Self; Ono Pharmaceutical Co., Ltd.. Speaker's Bureau; Self; Ono Pharmaceutical Co., Ltd.. Research Support; Self; Novartis Pharma K.K., Boehringer Ingelheim GmbH. Speaker's Bureau; Self; Boehringer Ingelheim GmbH. Advisory Panel; Self; Boehringer Ingelheim GmbH. Research Support; Self; Mitsubishi Tanabe Pharma Corporation. Speaker's Bureau; Self; Mitsubishi Tanabe Pharma Corporation. Advisory Panel; Self; Mitsubishi Tanabe Pharma Corporation. Research Support; Self; Daiichi Sankyo Company, Limited. Speaker's Bureau; Self; Daiichi Sankyo Company, Limited. Advisory Panel; Self; Daiichi Sankyo Company, Limited. Research Support; Self; Sanwa Kagaku Kenkyusho Co., Ltd.. Speaker's Bureau; Self; Sanwa Kagaku Kenkyusho Co., Ltd.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Novo Nordisk Inc.. Research Support; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Advisory Panel; Self; Sanofi. Research Support; Self; Sumitomo Dainippon Pharma Co., Ltd.. Speaker's Bureau; Self; Sumitomo Dainippon Pharma Co., Ltd.. Research Support; Self; Shionogi & Co., Ltd.. Speaker's Bureau; Self; Shionogi & Co., Ltd., Bayer Yakuhin, Ltd., Astellas Pharma US, Inc., AstraZeneca. Advisory Panel; Self; AstraZeneca, Teijin Pharma Limited.