Surprisingly few psychological problems and diabetes-related distress in patients with poor glycaemic control.

Objective: Poor glycaemic control is an undesirable, but frequently encountered problem in diabetes. Reasons for not achieving optimal glycaemic control are not yet clear. A common belief is that psychological factors contribute importantly. This study compared general psychological problems and diabetes-related distress between patients with persistently poor glycaemic control to patients with optimal glycaemic control.

Methods: Patients from an outpatient clinic with type 1 or type 2 diabetes with a mean HbA1c ≥ 86 mmol/mol (≥ 10%) over two consecutive years (poor-control, n = 32) and those with diabetes and a mean HbA1c ≤ 53 mmol/mol (≤ 7%) over two consecutive years (optimal-control, n = 53) were studied. Clinical characteristics were obtained from the medical records. Psychological characteristics were investigated cross-sectionally using questionnaires.

Results: Patients in the poor-control group had a higher BMI compared with the optimal-control group. Self- reported previous anxiety was more prevalent in the poor-control group (34 versus 9%). All other mean test scores and proportions of subjects above cut-off levels were similar in the two groups.

Conclusions: Patients with diabetes and persistently poor glycaemic control have surprisingly few psychological problems and diabetes-related emotional distress. It seems that people with diabetes do not see persistent poor glycaemic control as a problem.