The relationship between diabetes distress and HbA1C level in type 2 diabetes mellitus therapy patients: a systematic review

Introduction: The success of therapy did not follow the increasing number of type 2 diabetes mellitus patients. This systematic review aimed to evaluate the relationship between diabetes distress and HbA1c in type 2 diabetes mellitus patients during therapy. Methods: The authors systematically searched databases (PubMed, Cochrane library, and ScienceDirect) up to January 2021. Articles were screened according to PRISMA 2020 statements. The selection criteria of this study were patients’ characteristics, type of therapy, and outcomes. Results: The search started from 1.303 articles to 17 eligible articles. Furthermore, seventeen studies included 11,976 patients. The mean HbA1c level was around 6.4% to 9.9%. The result of diabetes distress scores were five studies with low scores, eight moderate scores, and two high scores. Emotional burden and regimen-related distress were the highest domain score. Age, health facilities, and type of therapy affected diabetes distress. The correlation between diabetes distress and HbA1c was dominant in the range of 0.15 to 0.26. Conclusion: Diabetes distress had a low-moderate correlation with HbA1c. The dominant domains were emotional burden and regiment-related distress. There were two mechanisms of effect, direct by hormones and indirect through medication adherence, self-management, and 12 months of quality of life.