Associations of Diabetes-Related Distress and Depressive Symptoms With Glycemic Control in Korean Americans With Type 2 Diabetes

Purpose: The purpose of this study was to investigate the associations of diabetes-related distress and depressive symptoms with glycemic control in Korean Americans (KAs) with type 2 diabetes mellitus (T2DM). Methods: The cross-sectional, correlational descriptive study explored glycemic control in KA. A total of 119 KA adults with T2DM were recruited from Korean communities in Arizona between July and November 2016. Data were collected by a finger-stick glucose test for A1C, the Diabetes Distress Scale for diabetes-related distress, the Center for Epidemiological Studies Depression for depressive symptoms, and sociodemographics. Height and weight were measured to calculate body mass index. Descriptive statistics, bivariate correlation, and multiple linear regression analyses were performed. Results: The total score for diabetes-related distress was positively associated with A1C in both unadjusted and adjusted models, while depressive symptoms were not associated with glycemic control regardless of analysis methods. In the further analysis of the 4 subscales of diabetes-related distress, only regimen-related distress was a significant predictor of poor glycemic control after adjusting for covariates. Emotional burden was not associated with glycemic control, even though there was a weak but significant correlation between emotional burden and glycemic control. Conclusions: Diabetes-related distress and depressive symptoms should be recognized as different psychological aspects in T2DM, and individual-centered approaches should be used for diabetes self-management education and support. In addition, diabetes-focused psychological interventions and culturally tailored diabetes self-management programs should be included in comprehensive education and support for KAs with T2D to achieve good glycemic control.