Diabetes Distress and Associated Factors Among Chinese Americans with Type 2 Diabetes in New York City

Yun Shi,1,2 Chan Wang,2 Mary Ann Sevick,1– 3 Han Bao,4 Xinyi Xu,1,2 Yulin Jiang,1,2 Ziqiang Zhu,5 Ashley Wei,1,2 Naumi M Feldman,6 Lu Hu1,2 1Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, New York, NY, USA; 2Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA; 3Department of Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA; 4Jacobi Medical Center, New York, NY, USA; 5Wellsure Medical Practice, New York, NY, USA; 6Charles B. Wang Community Health Center, New York, NY, USACorrespondence: Lu Hu, Center for Healthful Behavior Change, Institute for Excellence in Health Equity, NYU Langone Health, 180 Madison Ave, New York, NY, 10016, USA, Tel +1 646-501-3438, Email lu.hu@nyulangone.orgPurpose: The purpose of this study is to describe diabetes distress and related factors among Chinese Americans with type 2 diabetes in New York City (NYC).Methods: We conducted a secondary data analysis of the baseline data from three research studies conducted among community-dwelling Chinese American adults with type 2 diabetes. Diabetes Distress Scale (DDS) was used to measure sources of diabetes distress including emotional-, regimen-, interpersonal-, and physician-related distress. A score of 2 or greater indicates moderate diabetes distress or higher. Patient Health Questionnaire-2 (PHQ-2) was used to measure depressive symptoms. Participants’ sociodemographic information was also collected. Descriptive statistics were used to describe diabetes distress, and logistic least absolute shrinkage and selection operator (LASSO) regression was used to examine factors associated with diabetes distress level.Results: Data from 178 participants (mean age 63.55± 13.56 years) were analyzed. Most participants were married (76.40%), had a high school degree or less (65.73%), had a household annual income < &dollar;25,000 (70.25%), and reported limited English proficiency (93.22%). About 25.84% reported moderate or higher overall distress. The most common sources of distress were emotional burden (29.78%), followed by regimen- (28.65%), interpersonal- (18.54%), and physician-related distress (14.04%). Participants who were younger, female, limited English proficient, and had elevated depressive symptoms were more likely to have higher diabetes distress.Conclusion: Diabetes distress is prevalent among Chinese immigrants with type 2 diabetes, especially emotional- and regimen-related distress. Given the known link between diabetes distress and poor glycemic control, it is critical to screen for diabetes distress at primary care clinics and incorporate psychological counseling in diabetes care in this underserved population.Keywords: Chinese Americans, immigrant health, ethnic minority, diabetes distress, psychological burden, mental health, stress, emotional distress