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Development of a Brief Diabetes Distress Screening Instrument
Open accessAbstract
PURPOSE: Previous research has documented that diabetes distress, defined as patient concerns about disease management, support, emotional burden, and access to care, is an important condition distinct from depression. We wanted to develop a brief diabetes distress screen instrument for use in clinical settings. METHODS: We assessed 496 community-based patients with type 2 diabetes on the previously validated, 17-item Diabetes Distress Scale (DDS17) and 6 biobehavioral measures: glycated hemoglobin (HbA(1c)); non-high-density-lipoprotein (non-HDL) cholesterol; kilocalories, percentage of calories from fat, and number of fruit and vegetable servings consumed per day; and physical activity as measured by the International Physical Activity Questionnaire. RESULTS: An average item score of > or =3 (moderate distress) discriminated high- from low-distressed subgroups. The 4 DDS17 items with the highest correlations with the DDS17 total (r = .56-.61) were selected. Composites, comprised of 2, 3, and 4 of these items (DDS2, DDS3, DDS4), yielded higher correlations (r=.69-.71). The sensitivity and specificity of the composites were .95 and .85, .93 and .87, and .97 and .86, respectively. The DDS3 had a lower sensitivity and higher percentages of false-negative and false-positive results. All 3 composites significantly discriminated subgroups on HbA(1c), non-HDL cholesterol, and kilocalories consumed per day; none discriminated subgroups on fruit and vegetable servings consumed per day; and only the DDS3 yielded significant results on the International Physical Activity Questionnaire. Because of its psychometric properties and brevity, the DDS2 was selected as a screening instrument. CONCLUSIONS: The DDS2 is a 2-item diabetes distress screening instrument asking respondents to rate on a 6-point scale the degree to which the following items caused distress: (1) feeling overwhelmed by the demands of living with diabetes, and (2) feeling that I am often failing with my diabetes regimen. The DDS17 can be administered to those who have positive findings on the DDS2 to define the content of distress and to direct intervention.
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“Previous analyses identified that the DDS2 had good sensitivity and specificity with the DDS17 (7) and was considered a reliable screening composite for use in clinical practice.”
From When Is Diabetes Distress Clinically Meaningful? (2012) · cites this paper as [7]
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“Previous analyses identified that the DDS2 had good sensitivity and specificity with the DDS17 (7) and was considered a reliable screening composite for use in clinical practice.”
From When Is Diabetes Distress Clinically Meaningful? (2012) · cites this paper as [7]
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Johansen, C. (2014) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000141 · Cited by 16
“Furthermore, a large number of persons with diabetes suffer from diabetes distress, the semi-chronic stress condition resulting from the strains of living with diabetes [8-10].”
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“The assessment also included the Whitty 9-item questionnaire to assess diabetes symptoms [38], the brief two-item Diabetes Distress Scale to screen for distress [39], and the summary of Diabetes Self-Care Activities Questionnaire to assess self-reported adherence [40].”
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“Substantial evidence shows that depression among individuals with diabetes is associated with poorer diabetes outcomes [1] and higher levels of diabetes distress (emotional burdens, stresses, and worries associated with diabetes) [2].”
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Leung, C. W., Heisler, M., & Patel, M. R. (2022) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2022.101957 · Cited by 13
“Diabetes distress was assessed using the two-item Diabetes Distress Scale (Fisher et al., 2008).”
MethodCallan, J. A., Sereika, S. M., Cui, R., Tamres, L. K., Tarneja, M., Greene, B., Slyke, A. V., Wu, M., Lukac, G. R., & Dunbar‐Jacob, J. M. (2022) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106221133027 · Cited by 13
Turner, C. D., Lindsay, R. G., & Heisler, M. (2021) · The Annals of Family Medicine · doi:10.1370/afm.2742 · Cited by 14
Diabetes Distress in Adults Living With Type 1 and Type 2 Diabetes: A Public Health Issue
deMolitor, L., Dunbar, M. J., & Vallis, M. (2020) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2020.06.012 · Cited by 12
Nygaard, M. K., Willaing, I., Joensen, L. E., Lindgreen, P., Stenov, V., Hessler, D., Nørgaard, K., Pedersen‐Bjergaard, U., & Olesen, K. (2023) · Diabetes Care · doi:10.2337/dc23-0460 · Cited by 14
Impact of technology use in type 2 diabetes distress: A systematic review
Vieira, P., Kobayasi, R., Pereira, F., Zaia, I. M., & Sasaki, S. U. (2020) · World Journal of Diabetes · doi:10.4239/wjd.v11.i10.459 · Cited by 13
O’Donnell, M. B., Scott, S., ELLISOR, B. M., Cao, V. T., Zhou, C., Bradford, M. C., Pihoker, C., DeSalvo, D. J., Malik, F. S., Hilliard, M. E., et al. (2022) · Contemporary Clinical Trials · doi:10.1016/j.cct.2022.107017 · Cited by 12
Xie, B., Ye, X.-L., Sun, Z., Jia, M., Jin, H., Ju, C., Li, Y., Carvalho, V., & Yang, Y. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-747 · Cited by 12
“The third section is psychosocial status including knowledge of diabetes; activities of self-management [15], self-efficacy [16], adherence to medication [17,18], quality of life [19-21], diabetes distress screening [22,23], traits [24], life satisfaction [25], depression, anxiety and stress [26-28].”
BackgroundInfluences of Patient Activation on Diabetes Self-Care Activities and Diabetes-Specific Distress
Choi, S., & Kim, S. H. (2020) · Korean Journal of Adult Nursing · doi:10.7475/kjan.2020.32.1.10 · Cited by 12
“3) 당뇨병 관련 스트레스 당뇨병 관련 스트레스는 Fisher 등이 개발한 단축형 당뇨병 관련 스트레스 척도(Brief Diabetes Distress Screening instrument) [27]를 번역, 역번역 후 측정하였다.”
Burman, J., Bhattacharya, A., Chattopdhyay, A., Dey, I., Sembiah, S., & Negi, R. (2021) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_2070_20 · Cited by 13
“(<3: No distress, 4‐5: Mild to moderate, >5: Severely distressed).[13]”
BackgroundMartin, M., Patterson, J., Allison, M., O’Connor, B. B., & Patel, D. K. (2021) · JMIR Diabetes · doi:10.2196/24981 · Cited by 14
“Participants with high glycemic risk showed the greatest improvement in physical and mental health scores, with increases of 3.84 points (P .001) for GPH and 3.3 points (P=.001) for GMH. Improvements in diabetes distress were also significant across all groups (Table 3), where the average DDS-2 score improved by 0.57…”
BackgroundMethodInfluentialMenon, A., Gray, L., Fatehi, F., Darssan, D., Bird, D., Bennetts, D., & Russell, A. W. (2017) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x17733295 · Cited by 12
“If the score on DDS2 was equal or greater than three, the participants were then asked to complete the Diabetes Distress Scale 17-item questionnaire (DDS17).(19) The PAH DTS caters to many regional sites across Queensland including three Aboriginal Medical Services, and is based at the purpose-built centralised PAH Te…”
BackgroundHousni, A., Katz, A., Kichler, J., Nakhla, M. M., Secours, L., & Brazeau, A. (2024) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2024.103112 · Cited by 11
Sharp, L. K., Biggers, A., Perez, R., Henkins, J., Tilton, J., & Gerber, B. S. (2021) · JMIR Research Protocols · doi:10.2196/17170 · Cited by 11
“Health-related quality of life is measured using the EuroQol Group 5D and Diabetes Distress Scale [73].”
Olesen, K., Joensen, L. E., Madsen, K. P., & Willaing, I. (2022) · Frontiers in Clinical Diabetes and Healthcare · doi:10.3389/fcdhc.2022.867025 · Cited by 11
“Likewise, psychosocial data on diabetes distress (2-item Diabetes Distress Scale (DDS-2)) (24), quality of life (25) and worries related to diabetes and the pandemic (23) were collected from the baseline questionnaire.”
MethodGender: Does it have role has a role in glycaemic control and diabetic distress in type 2 diabetes?
Sasisekhar, T. V. D. (2013) · IOSR Journal of Dental and Medical Sciences · doi:10.9790/0853-0464851 · Cited by 10
Diabetes Distress and Quality of Life in Adults with Diabetes
Hoogendoorn, C. J., Shapira, A., Delgado, J. F. R., Kane, N. S., & Gonzalez, J. S. (2020) · Springer eBooks · doi:10.1007/978-3-030-33286-0_20 · Cited by 11
Danne, T., Joish, V. N., Afonso, M., Banks, P. L., Sawhney, S., Lapuerta, P., Davies, M. J., Buse, J. B., Lin, D., Reaney, M. D., et al. (2020) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2020.0068 · Cited by 12
“13 We used this cutoff to define high-and low-risk categories and investigated the shifts in risk category from baseline to week 24.”
Self-citationComplementarity of Digital Health and Peer Support: “This Is What’s Coming”
Tang, P. Y., Duni, J., Peeples, M. M., Kowitt, S. D., Bhushan, N. L., Sokol, R. L., & Fisher, E. B. (2021) · Frontiers in Clinical Diabetes and Healthcare · doi:10.3389/fcdhc.2021.646963 · Cited by 11
“Coaches probed emotional status using items from the Diabetes Distress Scale (34, 35) and reviewed individuals’ diabetes self-management, such as their familiarity with A1c and fasting blood glucose measures, selfmonitoring blood glucose, medication adherence, diet and exercise, and adherence to recommended clinic vis…”
MethodEducation of people with type 2 diabetes through peers with diabetes: is it cost effective?
González, L., Elgart, J. F., & Gagliardino, J. J. (2015) · Medwave · doi:10.5867/medwave.2015.11.6348 · Cited by 11
“c) Un cuestionario de detección de carga afectiva (estrés) de la diabetes [43] antes y después de los cursos de educación.”
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“2) Diabetes Distress Scale (DDS) [44]”
Lake, A. J., Rees, G., & Speight, J. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1007-3 · Cited by 10
Qian, Y., Emmerling, D., Kowitt, S. D., Ayala, G. X., Cherrington, A., Heisler, M., Safford, M. M., Tang, T. S., Thom, D. H., & Fisher, E. B. (2023) · Diabetic Medicine · doi:10.1111/dme.15065 · Cited by 14
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“Distress that manifests from the burden of living with diabetes [11], or diabetes distress , broadly refers to patient concerns about diabetes management, support, the emotional burden of the disease, and access to care [12].”
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“For instance, diabetesspecific anxiety in a study of 506 patients with type 2 diabetes showed the same results (23).”
BackgroundResultHo, E. Y., Pak, S., Leung, G. Y., Xu, S., Yu, C. K., Hecht, F. M., Jih, J., & Chao, M. T. (2020) · Health Equity · doi:10.1089/heq.2020.0002 · Cited by 10
“Feasibility and acceptability of the intervention were measured through postcourse evaluation that included open- and close-ended questions such as: what was your overall experience with diabetes nutrition education; would you recommend these classes to a friend with diabetes; is there anything you would change about…”
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Blanchette, J. E., Allen, N. A., & Litchman, M. L. (2022) · The Science of Diabetes Self-Management and Care · doi:10.1177/26350106221087474 · Cited by 10
Diabetes Attitude Scale: Validation in Type-2 Diabetes Patients in Multiple Centers in China
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Beverly, E. A., & Osowik, F. A. (2021) · Journal of Osteopathic Medicine · doi:10.1515/jom-2021-0091 · Cited by 10
“To facilitate routine screening for diabetes distress, osteopathic physicians can employ the abbreviated two item Diabetes Distress Scale [58].”
MethodInfluentialJanevic, M. R., Piette, J. D., Ratz, D., Kim, H., & Rosland, A.-M. M. (2015) · Diabetic Medicine · doi:10.1111/dme.13045 · Cited by 10
Predictors of diabetes distress among older persons with type 2 diabetes mellitus in Indonesia
Asshiddiqi, M. I. N., Yodchai, K., & Taniwattananon, P. (2020) · Journal of research in nursing · doi:10.1177/1744987120943936 · Cited by 9
“The mean score of the 17 items was used, with higher scores indicating greater distress (Fisher et al., 2008).”
MethodKelly, C. S., Nguyen, H. T. N., CHAPMAN, K. S. M., & Wolf, W. A. (2024) · Diabetic Medicine · doi:10.1111/dme.15425 · Cited by 9
Ho, E. Y., Leung, G. Y., Chao, M. T., Chan, D., Hsieh, E., Pritzker, S. E., Chi, H.-L., Huang, S., Ruan, Q., & Seligman, H. K. (2021) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2020.0558 · Cited by 9
“…an item querying how many of the last 7 days the respondent followed a healthful eating plan), diabetes distress (two-item Diabetes Distress Scale short form), 11 and self-efficacy (modified five-item Heisler’s Self-Efficacy Scale, assessing degree of diffi-culty with T2DM-related self-care activities).”
Fukuda, N., Gandhi, K., Lim, E., & Leake, A. (2019) · Europe PMC (PubMed Central) · Cited by 9
Development of the influence, motivation, and patient activation in diabetes (IMPACT-D™) measure
Arvanitis, M., Bailey, S. C., Wismer, G. A., Griffith, J. W., Freeman, E., Sims, T. J., Paczkowski, R., Klopchin, M. N., Chung, A. E., Carpenter, D. M., et al. (2019) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2019.107965 · Cited by 9
Olukotun, O., AKINBOBOYE, O. J., Williams, J. S., Ozieh, M. N., & Egede, L. E. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01058-9 · Cited by 9
“The 17-item instrument measures different dimensions of distress: access to care, support, emotional burden, and disease management [35].”
BackgroundProtocol refinement for a diabetes pragmatic trial using the PRECIS-2 framework
Glasgow, R. E., Gurfinkel, D., Waxmonsky, J. A., Rementer, J., Ritchie, N. D., Dailey-Vail, J., Hosokawa, P. W., Dickinson, L. M., & Kwan, B. M. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-07084-x · Cited by 9
Self-citationWooldridge, J. S., Soriano, E. C., Harris, D. E., & Afari, N. (2021) · Diabetes Spectrum · doi:10.2337/ds21-0020 · Cited by 9
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“(Male, 21, diagnosed age 18, interviewed at 6 months, External support worker arm) The young adults were also generally very supportive of the inclusion of a diabetes distress measure in the agenda-setting tool (DDS-2) [14].”
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“The most frequently used, diabetes-specific, and clinical-evidence based scales in determining diabetes distress are the 20-item PAID scale and 17-item Diabetes Distress Scale (DDS17) [5, 6, 10, 11].”
MethodInfluentialDuarte‐Díaz, A., González‐Pacheco, H., Rivero‐Santana, A., Ramallo‐Fariña, Y., Perestelo‐Pérez, L., Castro, W. P., Carrión, C., Serrano‐Aguilar, P., & INDICA Team (2022) · Health Expectations · doi:10.1111/hex.13501 · Cited by 8
“84).(45,47) Diabetes‐related quality of life.”
Gallo, L. C., Fortmann, A. L., Bravin, J. I., Clark, T. L., Savin, K. L., Ledesma, D. L., Euyoque, J. A., Sandoval, H., Roesch, S. C., Gilmer, T., et al. (2020) · Trials · doi:10.1186/s13063-019-3722-8 · Cited by 8
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Evaluating the Impact of Mobile Phone Technology on Health Outcomes for Latinos with Type 2 Diabetes
Jackson, L. V., Carpenter, D. M., Postlethwaite, D., Castro, L. C., Kim, E., & Herrera, R. A. (2020) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-020-00810-x · Cited by 7
Nance, C. M., Betancourt, H. M., & Flynn, P. M. (2022) · Journal of Behavioral Medicine · doi:10.1007/s10865-022-00301-w · Cited by 7
“The DDS-2 is a brief and psychometrically robust instrument with strong reliability (Fisher et al., 2008).”
BackgroundAyala, G. X., Chan, J. C. N., Cherrington, A., Elder, J. P., Fisher, E. B., Heisler, M., Howard, A. G., Ibarra, L., Parada, H., Safford, M. M., et al. (2022) · Annals of Behavioral Medicine · doi:10.1093/abm/kaab114 · Cited by 7
Pieri, B. A., Deshmukh, H., Wilmot, E. G., Choudhary, P., Shah, N. Z., Gregory, R., Barnes, D., Saunders, S., Patmore, J., Walton, C., et al. (2022) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14841 · Cited by 7
“Diabetes-related distress was measured using the twoitem diabetes distress screening tool (DDS2).(10) An average of the two questions of the DDS2 scale was calculated.”
MethodReza, A. S., Mohd, Z. N., & Kimura, L. W. (2015) · Practice in Clinical Psychology · Cited by 7
Fortmann, A. L., Philis‐Tsimikas, A., Euyoque, J. A., Clark, T. L., Vital, D. G., Sandoval, H., Bravin, J. I., Savin, K. L., Jones, J. A. M., Roesch, S. C., et al. (2020) · Contemporary Clinical Trials · doi:10.1016/j.cct.2020.106164 · Cited by 8
Occupational balance in people with type-2 diabetes: A comparative cross-sectional study
Binesh, M., Aghili, R., & Mehraban, A. H. (2020) · British Journal of Occupational Therapy · doi:10.1177/0308022620963745 · Cited by 7
“The interpersonal subscale represents the subject’s concerns about receiving appropriate support from friends and family members (Fisher et al., 2008).”
BackgroundZara, S., Kruse, J., Leveling, A. M., Schmitz, J., Hempler, I., & Kampling, H. (2022) · JMIR Research Protocols · doi:10.2196/38477 · Cited by 7
“Additionally, as many as 42% of patients with type 1 diabetes and 24% to 36% of patients with type 2 diabetes report pronounced diabetes-related distress [7] (defined as the emotional aspect of the burden of living with a mainly self-managed chronic disease) [8].”
BackgroundMcQueen, A., Nordheim, D. V., Caburnay, C. A., Li, L., Herrick, C., Grimes, L. M., Broussard, D. J., Smith, R. E., Lawson, D., Yan, Y., et al. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21070936 · Cited by 8
“…measures assessed at all 4 survey time points included Cohen’s 4-item perceived stress scale ( α = 0.56) [31], a 2-item diabetes distress scale [32,33], the Patient Health Questionnaire-2 (PHQ2) depression screener [34], an 8-item scale assessing self-efficacy for performing diabetes self-care…”
MethodInfluentialIverson, T., Alfares, H., Nijjar, G. S., Wong, J., Abbasi, E., Esfandiari, E., Lin, M., Petrella, R. J., Symes, B., Chudyk, A. M., et al. (2024) · PLOS Global Public Health · doi:10.1371/journal.pgph.0004071 · Cited by 6
Jones, A. S. K., Seaton, N., Brown, A., Jenkinson, E., Carroll, S., Dietz, K. C., Hudson, J. L., Wroe, A. L., & Moss-Morris, R. E. (2025) · Psychological Medicine · doi:10.1017/s003329172500090x · Cited by 6
“- Illness-specific distress : The Diabetes Distress Scale (DDS) is a 17-item diabetes-related distress questionnaire (Fisher et al., 2008), α DDSbaseline = 0.95.”
InfluentialA longitudinal study of the stress of poor glucose control and diabetes distress
Marengo, C., Aronson, B. D., Sittner, K. J., & Walls, M. L. (2019) · Journal of Health Psychology · doi:10.1177/1359105319893004 · Cited by 7
“A mean score of the two items from the DDS-2 are computed, with individuals scoring 3 or higher considered a screen positive for diabetes distress (Fisher et al., 2008).”
BackgroundMethodResultInfluentialAn Exploratory Mixed Methods Study of Diabetes self-management in Blind Americans
Heydarian, N. M., Hughes, A. S., & Morera, O. F. (2021) · Western Journal of Nursing Research · doi:10.1177/01939459211019421 · Cited by 6
“Participants also completed the Diabetes Distress Scale (DDS) (Fisher et al., 2008), a validated and widely used scale used to assess distress related to domains of having and self-managing diabetes, including emotional diabetes burden, distress pertaining to the diabetes self-management regimen, feeling a disconnect…”
InfluentialFranc, S., & Charpentier, G. (2025) · Diabetes Obesity and Metabolism · doi:10.1111/dom.16540 · Cited by 6
“77 79 The Diabetes Working Group envisages changes to current medical service provision, for example by inviting patients to complete standardized questionnaires prior to their consultation.”
Hawkins, J., Kloss, K. A., Funnell, M. M., Nwankwo, R. B., Schwenzer, C., Smith, F. N., & Piatt, G. (2021) · BMC Public Health · doi:10.1186/s12889-021-10613-2 · Cited by 7
Effects of allium cepa on ovarian torsion-detorsion injury in a rat model
Kula, H., İlgen, O., Kurt, S., & Yılmaz, F. (2023) · Journal of Turkish Society of Obstetric and Gynecology · doi:10.4274/tjod.galenos.2023.41763 · Cited by 6
Deshmukh, H., Adeleke, K. A., Wilmot, E. G., Folwell, A., Barnes, D., Walker, N. M., Saunders, S., Ssemmondo, E., Walton, C., Patmore, J., et al. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15434 · Cited by 6
Wellmann, I. A., Ayala, L. F., Rodríguez, J. J., Guetterman, T. C., Irazola, V. E., Palacios, E., Huffman, M. D., Rohloff, P. J., Heisler, M., Ramírez‐Zea, M., et al. (2024) · Implementation Science Communications · doi:10.1186/s43058-023-00539-8 · Cited by 6
Heisler, M., Mase, R., Brown, B., Wilson, S., & Reeves, P. J. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.01.006 · Cited by 6
Yared, Z., Blunden, S., & Stotland, S. C. (2020) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2020.06.011 · Cited by 6
Do Youth Want Psychosocial Screenings in Diabetes Clinic? Profiles of Acceptability
Wong, J. J., Hanes, S. J., Iturralde, E., Lanning, M. S., Naranjo, D. M., Tanenbaum, M. L., & Hood, K. K. (2020) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsaa112 · Cited by 6
Ssemmondo, E., Shah, N., Newham, M., Rigby, A., Buckland, R., Deshmukh, H., & Sathyapalan, T. (2025) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.16116 · Cited by 6
“The prevalence of high DDS decreased from 50% at baseline to 25% at 12 weeks in the intervention groups.”
InfluentialBenefits of 12-month peer support for diabetes self management sustained at 18 months
Liu, Y., Cai, C., Wu, X., Tang, P. Y., Coufal, M. M., Chen, H., Shen, L. M., Yu, W., Qian, Y., Luu, S., et al. (2024) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2024.111564 · Cited by 5
Hendrieckx, C., Husin, H. M., Russell‐Green, S., Halliday, J. A., Lam, B., Trawley, S. L., McAuley, S. A., Bach, L. A., Burt, M. G., Cohen, N. D., et al. (2023) · Diabetic Medicine · doi:10.1111/dme.15195 · Cited by 5
“24 Convergent validity of the DME-Q ‘Total satisfaction’ was established by the significant positive correlation with the DTSQ (diabetes treatment satisfaction) and negative correlation with the PAID (diabetes distress).”
BackgroundMohr, T. C., de Wit, M., Embaye, J., Ehrmann, D., Hermanns, N., Lehmann, G., Ortiz, M. T. A., Murillo, L. T., Winkley, K., Famiglietti, A. M., et al. (2024) · Diabetic Medicine · doi:10.1111/dme.15442 · Cited by 5
“…at least 6 months before study participation are eligible if they have a mean score ≥ 2 on the 2-item Diabetes Distress Scale (DDS-2), representing clinically meaningful diabetes distress, 23 and have access to the Internet on a smartphone or tablet/laptop/pc for the entirety of the study duration.”
Wong, S., Lew, J. K., Soon, W. S. W., Griva, K., Smith, H. E., & Lim, S. C. (2024) · Patient Education and Counseling · doi:10.1016/j.pec.2024.108482 · Cited by 5
Gupta, J., Khandelwal, D., Gupta, L., Dutta, D., Mittal, S., Khandelwal, R., & Chittawar, S. (2025) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/ijem.ijem_170_24 · Cited by 5
“[11] DDS includes 17 items measuring four dimensions: emotional burden (EB, 5 items), physician-related distress (PD, 4 items), regimen-related distress (RD, 5 items), and diabetes-related interpersonal distress (ID, 3 items).”
Using Social Media for More Engaged Users and Enhanced Health Communication in Diabetes Care
Gong, Z. H., & Lyford, C. P. (2022) · American Journal of Lifestyle Medicine · doi:10.1177/15598276211064832 · Cited by 6
“22 This scale asked participants to evaluate eight different items such as “ Feeling overwhelmed by the demands of living with diabetes.”
Maudrie, T. L., Aulandez, K. M. W., O’Keefe, V. M., Whitfield, F. R., Walls, M. L., & Hautala, D. S. (2022) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2022.06.004 · Cited by 5
“Diabetes distress was measured with the Diabetes Distress Scale-2.(39) Respondents were asked how bothered they were in the past month with 2 potential problems that people living with T2D may experience (feeling overwhelmed by the demands of living with diabetes and feeling that I am often failing with my diabetes re…”
BackgroundMethodInfluentialCarreira, M., de Adana, M. S. R., Pinzón, J. L., & Ortiz, M. T. A. (2023) · Frontiers in Clinical Diabetes and Healthcare · doi:10.3389/fcdhc.2023.1209236 · Cited by 5
Liarakos, A. L., Hasan, N. E., Crabtree, T. S. J., Leelarathna, L., Hammond, P. J., Hussain, S., Haq, M., Aslam, A. A., GATDULA, E. R., Gibb, F. W., et al. (2024) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2024.111597 · Cited by 5
Validation of a brief scale for the assessment of distress associated to bipolar disorder
Pascual-Sánchez, A., Montes, J. M. G., Río, C. J., & Saiz-Ruiz, J. (2018) · The European Journal of Psychiatry · doi:10.1016/j.ejpsy.2018.11.001 · Cited by 5
Metadata
- Authors
- Fisher, L., Glasgow, R. E., Mullan, J. T., Skaff, M. M., & Polonsky, W. H.
- Affiliations
- University of California, San Francisco (US)
- Kaiser Permanente (US)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2008-05-01
- Volume
- 6
- Issue
- 3
- Pages
- 246-252
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC2384991
- OpenAlex
- W1861477559
- Cited by
- 474
- References
- 14
- Citations by year
- 2026: 28 · 2025: 29 · 2024: 43 · 2023: 31 · 2022: 42 · 2021: 46 · 2020: 36 · 2019: 30 · 2018: 32 · 2017: 25 · 2016: 26 · 2015: 33 · 2014: 22 · 2013: 18 · 2012: 9
- FWCI
- 5.46
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of California, San Francisco
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-061937, DK062732, R01DK061937, R01DK062732)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Nursing › Research and Theory › Health Education and Validation
- Keywords
- diabetes distress, screening tool, type 2 diabetes, Diabetes Distress Scale, brief screening, psychometric properties, HbA1c, non-HDL cholesterol, physical activity, diet, emotional burden, disease management
- MeSH terms
- Aged, Depression, Major Depressive Disorder, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Lipoproteins, Male, Mass Screening, Middle Aged, Psychometrics, Self Care, Sensitivity and Specificity, Stress, Psychological, Comorbidity, Sickness Impact Profile
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