Diabetic distress and work-related stress among individuals with type 2 diabetes mellitus

Background: Work-related diabetes distress was a term introduced in the context of type 1 diabetes mellitus (T1DM). Currently, there are no studies evaluating the contribution of work-related stress to overall diabetes distress among employed persons with type 2 diabetes mellitus (T2DM). Methods: Adult patients over the age of 21 years with T2DM in full-time employment for over a year were interviewed after informed consent. Diabetes distress was identified with the 17-question diabetes distress scale (DDS) and work-related stress was evaluated using the Siegrist effort-reward imbalance (ERI) questionnaire. DDS scores >= 3.0 were considered significant diabetes distress and effort-reward ratio > 1.0 was considered indicative of work stress. Results: One hundred and thirteen patients consented. 68/133 (51.2%) had clinically significant diabetes distress. Work-related stress was seen in 67/113 (50.3%) of patients. Prevalence of work stress was higher among those with clinically significant diabetes distress (62%) compared to those without diabetes distress (38%) (p-value = 0.007). Spearman's Rho correlation between diabetic distress and effort-reward imbalance was found to be moderately positively correlated (rs = 0.27 [2 tailed] p =.002). Conclusions: Increased work stress that manifests as an imbalance between effort and reward is associated with increased diabetes distress among employed persons with T2DM. The measure of diabetes distress needs to include work stress as a component to complete the picture.