{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:01:58Z","timestamp":1787169718283,"version":"build-2736575974"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Diabetes-related distress and glycemic control are of a particular concern to primary care physicians because of the impact of the coronavirus disease 2019 pandemic on diabetic patients\u2019 lifestyle, psychological well-being and healthcare access. Our aim was to evaluate the relationship between diabetes-related distress and glycemic control in diabetic patients with Type 2 diabetes mellitus (T2DM) in primary care settings during the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>This cross-sectional study was conducted at primary healthcare clinics in a rural area in Egypt among 430 patients with T2DM during the period from September 2020 to June 2021. All patients were interviewed for their sociodemographic, lifestyle, and clinical characteristics. Diabetes-related distress was measured by the problem areas in the diabetes scale (PAID), where a total score of \u226540 indicated a severe diabetes-related distress. The most recent glycosylated hemoglobin (HbA1c) measurements were used to indicate the glycemic control. Quantile regression model (0.50 quantile) was used to perform the multivariate analysis to identify significant factors associated with HbA1c level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Most of the participants had a suboptimal glycemic control (92.3%), while 13.3% had severe diabetes-related distress. HbA1c level was significantly and positively correlated with the total PAID score and all its sub-domains. Multivariate quantile regression revealed that obesity, multi-morbidity, and severe diabetes-related distress were the only significant determinants of the HbA1c median level. Obese patients had significantly higher median HbA1c compared to patients who were not obese (coefficient = 0.25,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Patients with two or more comorbidities (i.e., multimorbidity) had a significantly higher median HbA1c than patients with single or no chronic comorbidities (coefficient = 0.41,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Severe diabetes-related distress was significantly associated with higher median HbA1c compared to nonsevere diabetes-related distress (coefficient = 0.20,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Diabetes-related distress had a significant association with HbA1c level. Family physicians should implement multifaceted programs to optimize diabetes control and reduce any associated distress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfcm.jfcm_238_22","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T17:24:05Z","timestamp":1691169845000},"page":"42-50","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Association between diabetes-related distress and glycemic control in primary care patients with Type 2 diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Egypt"],"prefix":"10.4103","volume":"30","author":[{"given":"Sally F.","family":"Elotla","sequence":"first","affiliation":[{"name":"Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Fouad","sequence":"additional","affiliation":[{"name":"Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar F.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar I.","family":"Joudeh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar"},{"name":"Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Mostafa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer El","family":"Hayek","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Jackson Health System, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaffer","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Public Health, New York State Department of Health, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem A. 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