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Six-country European Survey Finds Over Half of Adults with Diabetes in the UK and Italy Experience Anxiety

The study by Evelyn Cox from dQ&A – The Diabetes Research Company, San Francisco USA, and colleagues, surveyed adults with type 1 and type 2 diabetes from six Western European countries. It highlights the unique burden of mental health issues on people with diabetes and suggests a link between blood sugar management and severity of anxiety.

The study was presented at this year’s European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden (19-23 September 2022).

“Our survey results underline how vulnerable adults with diabetes are to generalised anxiety. In particular, women with diabetes and those younger than 45 may be more susceptible to experiencing anxiety, emphasising the need for greater support,” says Ms Cox.

She adds: “Our findings also indicate a link between blood sugar management and severity of anxiety. This underscores the need for a more integrated approach to diabetes management and mental health support to both minimise anxiety and improve blood sugar metrics targeted at high-risk groups.”

Previous research shows that people with diabetes have higher rates of mental health disorders, including generalised anxiety disorder (characterised by persistent and excessive worry), compared to the general population. But there has been little research on the relationship between diabetes management and generalised anxiety.

For this study, researchers conducted an online survey to collect data on demographic characteristics, anxiety, and blood sugar management metrics in 3,077 adults from the dQ&A EU research panel (average age 44, 52% female) living with type 1 diabetes (66%) or type 2 diabetes (34%) in France, Germany, Italy, Netherlands, Sweden, and the UK. Data were collected between October and November 2021. All respondents were compensated for completing the survey (€12 EUR).

Respondents were asked for their most recent haemoglobin A1c level (HbA1c, a measure of blood sugar control) if they knew it (2,561 participants); and those who used glucose sensors (2,011) were asked about the percentage of time in a typical day they spent in the target blood sugar range (between 70 and 180 mg/dl). All respondents completed the Generalised Anxiety Disorder questionnaire (GAD-7) to screen for, and measure, severity of anxiety.

The analyses found that people with diabetes living in Italy and the UK reported the highest rates of anxiety (63% and 51%, respectively), while those in the Netherlands reported the lowest rates (39%).

Across all six European countries studied, women with diabetes were more likely to report experiencing anxiety than men (57% vs 39%). And anxiety was more common among those younger than 45 years than those older – 59% and 34%, respectively.

The analyses also found that individuals with higher HbA1c over the past few months (greater than 7%) were more likely than those with lower HbA1c (equal or less than 7%) to report moderate (13% vs 10%) or severe anxiety (6% vs 4%).

Additionally, respondents using glucose sensors who spent less than 70% of a typical day in the target blood sugar range reported almost twice the rate of moderate or severe anxiety compared to those who spent 70% or more of their time in the target range (22% vs 14%).

“It is crucial that people with diabetes who experience challenges with their mental health reach out to their healthcare providers or mental healthcare practitioners for support,” says Cox. “Effective treatments are available and can considerably improve quality of life.”

Note: The authors are employees of dQ&A, a company that provides research services for a fee to clients in the diabetes field.

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