4.1 Introduction

Thirty seven NADC member Diabetes Centres responded to an ‘Expression of Interest’ and twenty four [24] NADC member Diabetes Centres participated and provided data on 1892 individuals [median 85 per Centre; mean 79 per Centre; range: (14–154)]. In all Tables - figures ‘excluding missing’ represent the % of all responses received [ie after excluding missing data].
[See Appendix 5 for Frequency Counts Data];
[See Appendix 6 for Data Tables & Graphs - Mean Descriptive Data].

4.2 Demographic Data

Table 2 lists the Demographic Characteristics of these individuals. By way of comparison, details are provided from the 2011 ANDIAB Data Collation for Age [years], Sex [%male], Duration [years], Diabetes Type and Therapy, Initial Visit status and Pregnancy.

As can be seen, ANDIAB2 2012 had 6.7% GDM individuals {representing 14.1% of females aged 15-55} contributing to the increase % female compared with ANDIAB 2011. Mean Age and Diabetes Duration were similar [3.2 years less and 0.8 years less respectively], distribution of Diabetes Types was similar [more GDM already noted], and as regards Therapy, this was similar except for more on Diet Only and less on Insulin versus ANDIAB 2011. For a significant percentage of these individuals, this was an Initial Visit - 27.0% [versus 13.5% in ANDIAB 2011]. Compared to 2010, individuals were similar age, with lower % male, shorter duration, less Type 1 diabetes and more on Diet, less on Insulin and similar numbers on Tablets or Insulin & Tablets.

Table 2 Demographic Data

Category2005 - n =
1405
Excluding
Missing
2010 - n =
2131
Excluding
Missing
2012 - n =
1892
Excluding
Missing
ANDIAB 2011 -
n = 5016
Age[Years]55.9 ± 16.453.6 ± 17.654.0 ± 16.857.2 ± 17.3
Sex [%] - Male44.7%45.5%50.4%50.7%46.9%47.1%54.3%
DM Duration [Years]8.5 ± 9.611.5 ± 10.810.1 ± 10.410.9 ± 9.7
Diabetes Type
Unstated0.1%0.2%0.3%1.3%
Type 115.6%27.5%21.2%22.9%
Type 276.3%67.3%70.3%72.6%
GDM6.0%3.7%6.7%1.8%
Other1.4%0.7%1.2%1.2%
Treatment
Unstated0.6%0.4%0.9%7.6%
Nil0.3%0.2%0.2%0.1%
Diet Only19.7%8.5%12.5%4.6%
Tablets35.9%25.2%26.6%24.9%
Insulin26.1%38.9%31.1%36.0%
Insulin & Tablets17.4%26.7%28.6%26.9%
Initial Visit23.8%24.2%25.6%25.7%27.0%27.3%13.5%
DVA Patient1.5%1.7%1.9%2.1%0.7%0.7%Not Collected
Interpreter Required5.4%6.2%3.5%4.0%3.1%3.5%Not Collected
NDSS Member85.1%88.4%85.4%92.2%80.8%92.6%Not Collected
Pregnant (139)28.3%29.7%19.3%20.0%26.1%28.6%11.3%
* Only Adults data [ANDIAB 2011]
** Only female patients aged 15-55

4.3 Lifestyle Issues Data

Table 3 lists Lifestyle Issues data. Overall 14.4% {14.5% of Yes/No respondents} were current smokers, and 76.6% {78.3% of Yes/No respondents} reported they had ‘Tried to Stop Smoking’.

Adequacy of Physical Activity [with only 45.7% adjudged as ‘sufficient’] was ascertained using the following definition [See Appendix 2 for all data definitions].

Physical Activity
Does the patient undertake sufficient Physical Activity?
Record as Sufficient / Insufficient / Sedentary

*Sufficient physical activity for health benefit for a usual 7-day period is calculated by - summing the total minutes of walking, moderate and/or vigorous physical activity. Vigorous physical activity is weighted by a factor of two to account for its greater intensity. Total minutes for health benefit need to be equal to or more than 150 minutes per week.

*Insufficient physical activity for health benefit is where the sum of the total minutes of walking, moderate and/or vigorous physical activity for a usual 7-day period is less than 150 minutes but more than 0 minutes.

*Sedentary is where there has been no moderate and/or vigorous physical activity during a usual 7-day period. The National Physical Activity Guidelines for Australians describes Moderate-intensity physical activity as causing a slight but noticeable, increase in breathing and heart rate and suggests that the person should be able to comfortably talk but not sing. Vigorous physical activity is described as activity, which causes the person to ‘huff and puff’, and where talking in a full sentence between breaths is difficult.
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Table 3 Lifestyle Issues
[December 2012]


Category2005 -
n
2005 -
%
2005 Exc
Missing
2010 -
n
2010 -
%
2010 Exc
Missing
2012 -
n
2012 -
%
2012 Exc
Missing
Smoker - Current14710.5%10.7%27512.9% 13.3%27314.4%14.5%
Smoker - PastNot CollectedNot CollectedNot Collected77736.5%37.5%70737.4%37.6%
Smoker - NeverNot CollectedNot CollectedNot Collected102147.9%49.3%90247.7%47.9%
Smoker tried to stop*10470.7%20173.1%75.8%20976.6%78.3%
Physical Activity - Sufficient74953.3%53.8%93744.0%45.8%86445.7%46.8%
Physical Activity - Insufficient48434.4%34.8%78736.9%38.4%72538.3%39.3%
Physical Activity - Sedentary15811.2%11.4%32415.2%15.8%25813.6%14.0%
Vaccination Flu73752.5%36.6%127960.0%63.4%108957.6%58.5%
Vaccination Pneumococcal23616.8%17.0%43920.6%21.9% 21511.4%11.7%
٭only patients who are current smokers

Table 3[a] Past Smokers – How they stopped

Category2012 n = 1892
n
2012 n = 1892
%
2012 n = 1892
% Exc
Missing
Past Smoker70737.4%37.6%
Just Stopped: No Intervention41021.7%62.2%
Hypnosis150.8%3.6%
Medication723.8%16.7%
Acupuncture90.5%2.2%
Nicotine Replacement904.8%20.7%
Other271.4%7.0%

In 2012 we also sought more information on Past Smokers in regards to the methods they used to cease smoking [Table 3a]. Most (62.2%) of the Yes/No respondents ‘Just Stopped’, 20.7% said they used ‘Nicotine Replacement’, and a further 16.7% used ‘Medication’, with less use of other options.

Overall 37.6% were Past Smokers. 196 ticked none of the options while 511 did with 440 ticking one response, 52 two, 12 three and 7 four options. No-one ticked five or all six options. These responses indicate that whilst a majority ‘Just Stopped’ Smoking, many needed to resort to help and many tried multiple different options before succeeding.

Also – a number of individuals who were Current Smokers who had ‘Tried to Stop’ Smoking also ticked some of these options (presumably things they tried [which failed]): 35 of the individuals did, with 13 ticking one response, 7 two, 11 three, 2 four and 2 five. No-one ticked all six options.
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Further analysis of reported Vaccinations indicated 57.6% have had a Flu Vaccination and 11.4% have had a Pneumococcal Vaccination [Table 3].

Tables 4a & 4b, indicate that the percentage of the Age Groups having Flu Vaccination increased from approx. 34% under 40, to 54.6% aged 40-59 and 73.4% over age 60, similar to 2010 data.

For Pneumococcal Vaccination, numbers were smaller and the relative age group population figures were highest for 60+, and substantially lower for 40-59 years and younger.

Table 4[a] Vaccination - Influenza past 12 months by Age Group

Age GroupInfluenza2005 n=2005 - % of
Age Group
2010 n=2010 - % of
Age Group
2012 n=2012 - % of
Age Group
<20Yes624.0%3534.7%1534.1%
20-39Yes5021.0%17141.9%13433.6%
40-59Yes19340.5%39655.3%35154.6%
60+Yes47074.5%67275.3%57573.4%

Table 4[b] Vaccination - Pneumococcal past 12 months by Age Group

Age GroupInfluenza2005 n=2005 - % of
Age Group
2010 n=2010 - % of
Age Group
2012 n=2012 - % of
Age Group
<20Yes28.0%87.9%22.0%
20-39Yes104.2%368.8%122.9%
40-59Yes357.3%10014.0%385.3%
60+Yes18128.7%29332.8%15917.8%

Looking at these data by Diabetes Type, [Tables 4c & 4d], 73.4% of Type 1 and 70.5% of Type 2 individuals had a Flu Vaccination with a Mean age of 45.2 and 62.6 years respectively. This is more than in previous ANDIAB2 surveys.

For Pneumococcal Vaccination, figures were 7.0% and 13.4% at Mean ages of 58.3 and 68.0 years for Type 1 and Type 2 respectively. This is much less than in previous ANDIAB2 surveys.

Table 4[c] Vaccination – Influenza by Diabetes Type

DM TypeInfluenza2005
n =
2005
% who
responded
2005
Mean ± SD
Age
2010
n =
2010
% who
responded
2010
Mean ± SD
Age
2012
n =
2012
% who
responded
2012
Mean ± SD
Age
Type 1Yes9844.7%46.2 ± 17.629550.3%41.2 ± 16.820473.4%45.2 ± 17.5
Type 2Yes62458.2%65.3 ± 11.193965.4%63.7 ± 11.684070.5%62.6 ± 12.4

Table 4[d] Vaccination - Pneumococcal by Diabetes Type

DM TypePneumococcal2005
n =
2005
% who
responded
2005
Mean ± SD
Age
2010
n =
2010
% who
responded
2010
Mean ± SD
Age
2012
n =
2012
% who
responded
2012
Mean ± SD
Age
Type 1Yes2411.0%44.9 ± 19.96811.6%44.0 ± 17.4287.0%58.3 ± 17.4
Type 2Yes20519.1%69.1 ± 9.935925.0%66.9 ± 10.717913.4%68.0 ± 11.3

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4.4 Self-care Data

In ANDIAB2 2012, since nothing was done to address deficiencies found in 2005 and confirmed in 2010 in regards to carrying identification, carrying hypoglycaemia treatment (if relevant), or informing the Traffic Authority (if a Driver), there seemed little point in collecting these data again, so the fields were removed. New data items for 2012 sought more information on the Selfcare issues of Diet – specifically more items seeking information on diet adherence [Table 5]; there were more items on smoking cessation [Table 3a] (above), and more medication use data {see 4.6 (below) and [Table 7]}.

The area of diabetes patient self-care behaviour assessed here was whether the individual had difficulties following their prescribed diet [Tables 5].

Table 5 Self-care

Category2012 n = 1892
n
2012 n = 1892
%
2012 n = 1892
% (Exc Missing)
Do you have difficulties following your prescribed diet?72438.3%39.6%
I don't have enough time to prepare healthy meals?25813.6%26.1%
It costs too much to eat well?31316.5%31.8%
I don't know what foods are best to eat?23012.2%23.5%
I eat out a lot and find it hard to eat well?1638.6%16.7%
If Type 1 - It is too hard to count carbs - weigh food?1065.6%33.5%

Overall, 38.3% indicated difficulties following their prescribed diet. Of these, 151 ticked none of the listed options, while 573 did, with 312 ticking one response, 152 two, 77 three and 32 four. Noone ticked all five options. [See Appendix 2 for all data definitions].

4.5 Assessment Data

Table 6 lists the assessment data for Lipohypertrophy, Lipoatrophy or Both. Looking at the figures excluding the 9 individuals who were on insulin marked ‘not relevant’, [where we are uncertain what ‘not relevant’ means (-it should mean not on insulin)], there was a reported 11.5% Lipohypertrophy, 0.9% Lipoatrophy and of these, 1.5% with both.

Table 6 Assessment

CategoryExcluding Not Relevant
2005 n = 1405
Excluding Not Relevant
2005 n = 1405
Excluding Not Relevant
2005 n = 1405
Excluding Not Relevant
2005 n = 1405
Insulin Rx **
2005 n = 1405
Insulin Rx **
2005 n = 1405
Insulin Rx **
2005 n = 1405
N %% (Exc Missing) Total%% (Exc
Missing)
Total
Lipohypertrophy*8813.0%14.3%67714.4%15.1%611
Lipoatrophy*223.3%3.6%6703.6%3.8%611
Both*203.2%3.3%6193.3%3.4%611
CategoryExcluding Not Relevant
2010 n = 2131
Excluding Not Relevant
2010 n = 2131
Excluding Not Relevant
2010 n = 2131
Excluding Not Relevant
2010 n = 2131
Insulin Rx **
2010 n = 2131
Insulin Rx **
2010 n = 2131
Insulin Rx **
2010 n = 2131
n%% (Exc
Missing)
Total%% (Exc
Missing)
Total
Lipohypertrophy*20813.9%15.1%149714.9%15.5%1400
Lipoatrophy*271.8%2.0%14961.9%2.1%1400
Both*231.7%1.7%13781.6%1.8%1400
CategoryExcluding Not Relevant
2012 n = 1892
Excluding Not Relevant
2012 n = 1892
Excluding Not Relevant
2012 n = 1892
Excluding Not Relevant
2012 n = 1892
Insulin Rx **
2012 n = 1892
Insulin Rx **
2012 n = 1892
Insulin Rx **
2012 n = 1892
n%% (Exc
Missing)
Total%% (Exc
Missing)
Total
Lipohypertrophy*15111.6%13.3%130613.4%13.9%1131
Lipoatrophy*120.9%1.1%13061.1%1.1%1131
Both*70.6%0.6%11370.6%0.7%1131

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*only patients on insulin
** includes 10 marked not relevant in 2005 and includes 9 marked not relevant in 2010, and includes 9 marked not relevant in 2012.

Some of these data were incorrect in 2005 and 2010 – Corrected in 2012.

4.6 Medication Use Data
In ANDIAB2 2012 we sought more information on Medication Use. Individuals were asked several questions in regards to Medication Use [Table 7]. Of note 82.7% claimed to “usually take all of their medications” [therefore 17.3% admitted to NOT do so], and whilst 30.9% admitted to the use of Complimentary Therapy [“herbal/homeopathic/essential oil/vitamin or mineral supplement”] or Dietary Supplement or OTC Rx, over 85% [85.8%] of these stated that they HAD informed their Doctor or Diabetes Educator of this fact.

Table 7 Medication use


Category2012 n = 1892
n
2012 n = 1892
%
2012 n = 1892
% Exc Missing
Do you ever forget to take your medications?43322.9%23.9%
Do you usually take all of your medications?156582.7%87.7%
Do you sometimes stop taking your medications when you feel better?1427.5%8.0%
Do you sometimes stop taking your medications when you feel worse?1427.5%8.0%
Are you using a complementary therapy or dietary supplement or OTC Rx?58530.9%32.9%
Have you told your Dr/Educator about complementary, dietary supplement, OTC Rx?*50285.8%86.7%

*only patients on complementary Rx

Of those patients who indicated that they do forget their medications, 46.7% indicated a frequency of once per week, 35.1% indicated 2-3 times per week, and 17.6% indicated >3 times per week [range 3-8]. An additional 76 indicated yes but left the number of times field blank (so we changed the yes to no). These are thus missing data values [where the field was not completed], but some or even all may represent cases where they forget to take medications less frequently than weekly - [data not shown in Table].

4.7 Brief Case-find for Depression [BCD] / Psychiatric Treatment Data

In 2002, four questions were added to ANDIAB. These can be used to calculate whether depression is ‘likely’ / ‘unlikely’ on the basis that a Yes to either or both of the first two questions ([a] or [b]) AND a Yes to either or both of the second two questions ([c] or [d]), makes ‘depression likely’. [BCD© 1993 Monash University Department of Psychological Medicine: used with permission].
The questions [relating to the last two weeks] are :
[a] Have you been having restless or disturbed nights? Yes/No
[b] Have you been feeling unhappy or depressed? Yes/No
[c] Have you felt unable to overcome your difficulties? Yes/No
[d] Have you been dissatisfied with the way you have been doing things? Yes/No

Table 8 shows the % Yes ‘depression likely’ of the total patient population, with results in the next column being the % of those who responded Yes or No to the questions. Overall a BCD calculation could be made for 87.4% [compared with 90.4% of individuals in ANDIAB 2010 and 99.6 % of individuals in ANDIAB2 2005].

As can be seen from the Table, the reported Likely Depression was 24.2% (versus 25.6% in ANDIAB2 2010 and 26.0% in ANDIAB2 2005).

Table 8 BCD Depression

Category2005 n = 1405

n
2005 n = 1405

%
2005 n = 1405

% (Exc
Missing)
2005 n = 1405

Total
2010 n = 2131

n
2010 n = 2131

%
2010 n = 2131

% (Exc
Missing)
2010 n = 2131

Total
2010 n = 1892

n
2010 n = 1892

%
2010 n = 1892

% (Exc
Missing)
2010 n = 1892

Total
Likely Depression Yes36526.0%26.1%140054525.6%28.3%192645824.2%27.7%1654
BCD calculated for99.6%90.4%87.4%
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Additional information was sought regarding whether individuals have/have had Current or Previous Psychiatric Treatment/Counselling. Overall these data were 87.1% complete [compared with 89.7% complete in ANDIAB2 2010 and 99.4% complete in ANDIAB2 2005] and the results shown in Table 9 are the % Yes of the total patient population, with results also for the % of those who responded Yes or No [ie excluding missing data]. The data shown in the Table indicate that the reported Current and Previous Psychiatric Treatment were 6.8% and 20.1% respectively, very similar to what was reported previously (6.4% and 19.2% in ANDIAB2 2010 & 6.5% and 16.6% in ANDIAB2 2005).

Table 9 Psychiatric Treatment

Category2005 n = 1405

n
2005 n = 1405

%
2005 n = 1405

% Exc
Missing
2005 n = 1405


Total
2010 n = 2131


n
2010 n = 2131

%
2010 n = 2131

% (Exc
Missing)
2010 n = 2131

Total
2012 n = 1892

n
2012 n = 1892

%
2012 n = 1892

% Exc
Missing
2012 n = 1892

Total
Current Yes926.5%6.6%13961376.4%7.2%19081286.8%7.8%1646
Previous Yes23316.6%16.7%139640919.2%21.4%190938120.1%23.2%1645
Completed for99.4%89.7%87.1%
These data were supplemented by asking “Is the patient taking antidepressant medication (not prescribed for peripheral neuropathy)?” and the results [Table 10], show findings similar to those reported in ANDIAB2 2010 and 2005 with 14.7% of all patients reportedly on Antidepressants – the overwhelming majority being those with Likely [versus Unlikely] Depression as per the BCD, 27.9% versus 9.4% respectively, again similar to previous surveys.

Table 10 On Antidepressant

Category2005 n = 1405

n
2005 n = 1405

%
2005 n = 1405

% Exc
Missing
2005 n = 1405

Total
2010 n = 2131

n
2010 n = 2131

%
2010 n = 2131

% Exc
Missing
2010 n = 2131

Total
2012 n = 1892

n
2012 n = 1892

%
2012 n = 1892

% Exc
Missing
2012 n = 1892

Total
Depression (BCD) likely9626.3%26.3%36516830.8%31.1%54512827.9%28.0%458
Depression (BCD) unlikely747.1%7.2%10351269.1%9.2%13811139.4%9.5%1196
Total on Antidepressant17012.1%12.2%140029615.4%15.5%191724314.7%14.8%1650
Completed for99.6%90.0%87.2%

4.8 Health Professional Attendance Data

Information was sought about Health Professional [HP] Attendance in the last 12 months, and the findings are summarized in Table 11 [again with results in an adjacent column being the % of those who responded Yes or No]. Of the latter, relatively few had seen a Psychologist, Social Worker or Exercise Physiologist, with 64.2% having seen a Specialist 75.9% a Diabetes Educator, and almost half had seen a Dietitian and / or a Podiatrist 48.3% & 49.3% respectively. Looking more closely at ‘Attended Ophthalmologist or Optometrist’, 36.2% had seen both [30.6% in 2010], 28.4% had seen an Optometrist only [26.7% in 2010] and 16.4% had seen an Ophthalmologist only [18.7% in 2010]. Thus 70.3% had seen either an Ophthalmologist or Optometrist or both [76.0% in
2010] [data not shown in Table].

Table 11 HP attendance

Category2005 n = 1405

n
2005 n = 1405

%
2005 n = 1405

% Exc
Missing
2005 n = 1405

Total
2010 n = 2131

n
2010 n = 2131

%
2010 n = 2131

% Exc
Missing
2010 n = 2131

Total
2010 n = 1892

n
2010 n = 1892

%
2010 n = 1892

% Exc
Missing
2010 n = 1892

Total
Attended Diabetes Specialist88362.8%63.4%1393145268.1%69.9%2077117662.2%64.2%1832
Attended DentistNot Collected in 2005Not Collected in 2005Not Collected in 2005Not Collected in 200592943.6%45.2%205686545.7%47.3%1830
Attended Dietitian68849.0%49.4%1393105249.4%51.1%205988446.7%48.3%1829
Attended Educator96868.9%69.5%1392144267.7%69.6%2071139073.5%75.9%1832
Attended Exercise PhysiologistNot Collected in 2005Not Collected in 2005Not Collected in 2005Not Collected in 20051185.5%5.8%2051995.2%5.5%1809
Attended OphthalmologistNot Collected in 2005Not Collected in 2005Not Collected in 2005Not Collected in 2005105049.3%50.9%206182743.7%45.4%1822
Attended OptometristNot Collected in 2005Not Collected in 2005Not Collected in 2005Not Collected in 2005122057.3%59.2%2061103054.4%57.5%1791
Attended Podiatrist57440.9%41.1%1398102348.0%49.2%207990247.7%49.3%1831
Attended Psychologist1077.6%7.7%13952069.7%10.0%205920010.6%10.9%1828
Attended Social Worker956.8%6.9%13851406.6%6.9%20391387.3%7.6%1820
Attended 0 (excl Specialist)24117.2%1405904.2%21311075.7%1892
Attended 1 (excl Specialist)31222.2%1919.0%1648.7%
Attended 2 (excl Specialist)50936.2%38718.2%31516.6%
Attended 3 (excl Specialist)27619.6%46721.9%41121.7%
Attended 4 (excl Specialist)614.3%43520.4%41321.8%
Attended 5 (excl Specialist)60.4%34616.2%29515.6%
Attended 6 (excl Specialist)N/AN/A1697.9%1387.3%
Attended 7 (excl Specialist)N/AN/A391.8%392.1%
Attended 8 (excl Specialist)N/AN/A60.3%100.5%
Attended 9 (excl Specialist)N/AN/A10.05%00.00%
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4.9 Quality of Life EQ-5D Assessment Data

An attempt was made to assess patient’s Quality of Life and their perceived Self-Assessed Own Health State Rating, based on the EQ-5D instrument developed by the EuroQol Group Copyright Symbol 2004 [with permission]. Individuals were asked to rate their own health status on a 0% [poor {or worst imaginable health state}] to 100% [excellent {or best imaginable health state}] scale, as was done in ANDIAB2 2005 and 2010. Diabetes Centre staff then transcribed the results to the scannable form for that individual.

The Diabetes Distress Scale [DDS]7 was chosen to assess diabetes-related emotional distress. It is a validated 2 screening question, 17 item questionnaire. The DDS17 yields a total diabetes distress scale score plus 4 sub scale scores, each addressing a different kind of distress, these being: Emotional Burden; Physician-related Distress; Regimen-related Distress; Interpersonal Distress. A mean item score of 3 or higher (moderate distress) is considered as a level of distress worthy of clinical attention. In 2012 the authors published a revision of DDS interpretation 8, suggesting 3 patient subgroups: little or no distress, <2.0; moderate distress, 2.0–2.9; high distress, ≥3.0.

Adopting the findings of 2010 where few patients with Screening Question results under 3 were found to have elevated readings on the 17 item questionnaire, in 2012 we advised that the 17 item questionnaire ONLY be administered when one or both screening questionnaire results >3.

Sites were given the following instructions re the DDS and 3 options for scoring:
  • If either Screening Question in ‘A’ is scored 3 or above the patient should complete the additional DDS 17 item questionnaire and computed score results should be entered in ‘B’ on the Data Field Definitions Form in the Quality of Life Assessment section.
How to score the 17 Item DDS Questionnaire
There are 3 Options:
[1] Manually calculate the 5 required items using the Score Sheet Provided;
[2] Utilise the DDS Calculator Tool provided. This is an application that you can save to your desktop, double click on the icon, and enter the 17 Individual Scores, then press the ‘Calculate’ button;
[3] Log onto the Diabetes Centre Website [Bankstown-Lidcombe Hospital]
Diabetes Centre - Diabetes Education Resources
Click on Diabetes Distress Scale on the left;
Enter the 17 Individual Scores, then press the ‘Calculate’ button.

Note
[a] You should only calculate the total DDS Score if 14 or more questions have been answered [and the Calculators [2]&[3] above will only work], when 14 or more answers are entered.
[b] You should not calculate any of the other 4 items if more than one item in that section has not been answered [and the Calculators [2]&[3] above will NOT work for the individual items when 2 or more items are missing].

Once DDS Scores had been calculated, Diabetes Centre staff then transcribed the results to the scannable form for that individual.

Regarding [2] & [3] above we developed, tested and implemented a DDS Calculator to automate the scoring of the DDS and its sub scales in ANDIAB2. This was used again as it was in 2010.

[See Appendix 3 for the Self-Assessment of Health Status Form, the full DDS17 Questionnaire and the DDS Scoring Sheet ].

Assessments of ‘Own Health Status’ were collated and are reported by: Diabetes Type and Age Group; with DiabCo$t9 data provided [with permission] for comparison; and for Type 2 diabetes by diabetes management method. Diabetes Distress Scale scores are presented as Screening, Total and Sub scale scores by Diabetes Type and by aspects of Screening Question responses. The findings are summarised in Tables 12, 12[a]-[d], 13, 14, and 14[a]-[d] on Pages 13-17.

Firstly, as shown in Table 12, individuals rated their ‘Own Health Status’ as a mean + SD of 64.4 + 20.1% [on the 0 to 100% scale], with reasonably similar findings for Type 1 and Type 2 - {65.1% T1 DM : 63.7% T2 DM : 72.7% GDM [n= 388, 1151 and 54 respectively]}. These
results were similar to those reported in ANDIAB2 2010 (but higher for GDM).

Table 12 EQ-5D Own Health Rating


Category2005 n = 1405

Mean ± SD

2005 n = 1405

n

2010 n = 2131

Mean ± SD

2010 n = 2131

n

2012 n = 1892

Mean ± SD

2012 n = 1892

n

Own Health Rating - All69.7 ± 21.3136763.1 ± 20.5184964.4 ± 20.11621
Own Health Rating - Type 171.0 ± 21.520865.6 ± 19.250865.1 ± 19.8388
Own Health Rating - Type 269.6 ± 20.7104662.0 ± 21.1127363.7 ± 20.11151
Own Health Rating - GDM69.2 ± 28.88464.0 ± 17.84372.7 ± 16.754

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‘Own Health Status’ assessments were analysed by Diabetes Type and Age Group - Table 12[a].

Table 12[a] EQ-5D Own Health Rating by Age Group and Diabetes Type


Age2005 n = 1405

All / Mean ± SD
2005 n = 1405

All / N
2005 n = 1405

Type 1 / Mean ± SD
2005 n = 1405

Type 1 / n
2005 n = 1405

Type 2 / Mean ± SD
2005 n = 1405

Type 2 / N
2010 n = 2131

All / Mean ± SD
2010 n = 2131

All / N
2010 n = 2131

Type 1 / Mean ± SD
2010 n = 2131

Type 1 / N
2010 n = 2131

Type 2 / Mean ± SD
2010 n = 2131

Type 2 / N
5-1884.7 ± 17.4784.7 ± 17.47±078.4 ± 19.82178.4 ± 19.828±0
16-3572.8 ± 21.819375.4 ± 17.09967.8 ± 23.03364.8 ± 19.732165.8 ± 19.127258.4 ± 23.940
36-5064.6 ± 23.524561.7 ± 23.25565.8 ± 22.417260.5 ± 20.035362.5 ± 19.414559.0 ± 20.5237
51-6567.9 ± 21.048967.3 ± 25.13768.0 ± 20.845461.8 ± 20.663967.5 ± 17.911260.9 ± 20.9606
66+73.2 ± 19.040180.4 ± 17.21273.0 ± 19.139264.6 ± 21.150262.7 ± 19.82664.6 ± 21.2542


Age2012 n = 1892


All / Mean ± SD
2012 n = 1892


All / N
2012 n = 1892


Type 1 / Mean ± SD
2012 n = 1892


Type 1 / n
2012 n = 1892


Type 2 / Mean ± SD
2012 n = 1892


Type 2 / N
5-18±0±0±1
16-3562.9 ± 19.325562.7 ± 19.718456.1 ± 19.061
36-5062.3 ± 21.131564.7 ± 20.410560.4 ± 20.9245
51-6564.5 ± 20.257970.1 ± 17.98163.6 ± 20.3557
66+66.4 ± 19.446365.7 ± 21.43066.2 ± 19.3452

DiabCo$t9 are data provided for comparison - Table 12[b] below. The DiabCo$t visual analogue scale was 0-1 [ours 0-100], thus a DiabCo$t score of 0.76 equates to 76% on our assessment scales. These results were all lower than those reported in DiabCo$t.

Table 12[b] DiabCo$t Own Health Rating by Age Group and Diabetes Type

Diabcost Overall Quality of Life by Age Group

AgeGeneral Population*DiabCo$t Type 1DiabCo$t Type 2
5-15-0.84-
16-350.920.76-
36-500.880.770.83
51-650.840.740.80
66+0.790.700.78

* Hawthorne et al, 200110
Also presented for interest are the DiabCo$t data for Type 1 diabetes by complication status (for which we do NOT have comparative results) - Table 12[c].

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Table 12[c] DiabCo$t Own Health Rating Type 1 DM by Complications

Diabcost


No ComplicationsMicrovascular complicationsMacrovascular complicationsBoth
EQ-5D scores
Number of respondents evaluable17272491683
Index Mean (SD)0.90 (0.17)0.73 (0.28)0.68 (0.40)0.65 (0.36)

Assessment of ‘Own Health Status’ are reported for Type 2 diabetes by diabetes management method - Table 12[d]. These results were similar to those reported in ANDIAB2 2010.

Table 12[d] EQ-5D Own Health Rating Type 2 DM by Management Method

Diabetes Management
Method
2005 n = 1405

Type 2

Mean ± SD
2005 n = 1405

Type 2

N
2010 n = 2131

Type 2

Mean ± SD
2010 n = 2131

Type 2

N
2012 n = 1892

Type 2

Mean ± SD
2012 n = 1892

Type 2

N
Diet Only74.4 ± 20.819466.4 ± 23.212169.3 ± 19.2139
Tablets70.0 ± 18.950063.5 ± 21.053464.9 ± 19.3493
Insulin68.3 ± 22.013157.7 ± 20.523059.4 ± 21.0173
Insulin and Tablets65.2 ± 22.623961.2 ± 20.854162.6 ± 20.5513
Nil±060.0 ± 14.1380.0 ± 5.04

Diabetes Distress Scale [DDS] scores are presented as Screening, Total and Sub scale scores by Diabetes Type and by aspects of Screening Question responses - Tables 13, 14 and 14[a].

Table 13 DDS Screening Question Mean Scores by Diabetes Type


Category2005 n = 1405
Mean ± SD
2005 n = 1405
N
2010 n = 2131
Mean ± SD
2010 n = 2131
N
2010 n = 2131
N >= 3
2010 n = 2131
%
ScreeningScaleQ1 - AllNot collected in 2005Not collected in 20052.2 ± 1.3187462833.5%
ScreeningScaleQ1 - Type 1Not collected in 2005Not collected in 20052.3 ± 1.251219337.7%
ScreeningScaleQ1 - Type 2Not collected in 2005Not collected in 20052.1 ± 1.3128741031.9%
ScreeningScaleQ1 - GDMNot collected in 2005Not collected in 20052.0 ± 1.1491632.7%
ScreeningScaleQ2 - AllNot collected in 2005Not collected in 20052.3 ± 1.4187362533.4%
ScreeningScaleQ2 - Type 1Not collected in 2005Not collected in 20052.4 ± 1.351120139.3%
ScreeningScaleQ2 - Type 2Not collected in 2005Not collected in 20052.2 ± 1.4128740731.6%
ScreeningScaleQ2 - GDMNot collected in 2005Not collected in 20051.8 ± 1.049918.4%

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Category2012 n = 1892
Mean ± SD
2012 n = 1892
n
2012 n = 1892
N >= 3
2012 n = 1892
%
ScreeningScaleQ1 - All2.1 ± 1.3156046930.1%
ScreeningScaleQ1 - Type 12.3 ± 1.337014238.4%
ScreeningScaleQ1 - Type 22.1 ± 1.3110931128.0%
ScreeningScaleQ1 - GDM1.8 ± 1.153815.1%
ScreeningScaleQ2 - All2.2 ± 1.4156049631.8%
ScreeningScaleQ2 - Type 12.6 ± 1.437015943.0%
ScreeningScaleQ2 - Type 22.1 ± 1.4110932329.1%
ScreeningScaleQ2 - GDM1.5 ± 0.853713.2%

Table 14 DDS Question Mean Total & Sub-scale Scores by Diabetes Type


Category2005 n = 1405

Mean ± SD / %
2005 n = 1405

n
2010 n = 2131

Mean ± SD / %
2010 n = 2131

N
2012 n = 1892

Mean ± SD / %
2012 n = 1892

n
DDS 17 Questionnaire DoneDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 200549.7%106041.8%790
Total DDS Score - AllDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.0 ± 0.910592.1 ± 0.9780
Total DDS Score - Type 1Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.0 ± 0.73342.2 ± 0.8230
Total DDS Score - Type 2Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.0 ± 0.96812.1 ± 0.9526
Total DDS Score - GDMDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.4 ± 0.5291.7 ± 0.614
Emotional Burden - AllDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.4 ± 1.210602.5 ± 1.2780
Emotional Burden - Type 1Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.4 ± 1.13352.6 ± 1.1230
Emotional Burden - Type 2Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.4 ± 1.26812.5 ± 1.3525
Emotional Burden – GDMDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.7 ± 0.8292.2 ± 1.115
Physician-related Distress - AllDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.5 ± 0.910591.5 ± 0.9779
Physician-related Distress - Type 1Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.4 ± 0.73341.5 ± 0.8230
Physician-related Distress - Type 2Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.6 ± 1.06811.5 ± 1.0525
Physician-related Distress - GDMDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.1 ± 0.4291.0 ± 0.114
Regimen-related Distress - AllDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.2 ± 1.110602.4 ± 1.2778
Regimen-related Distress - Type 1Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.3 ± 1.03352.5 ± 1.2230
Regimen-related Distress - Type 2Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20052.2 ± 1.26812.4 ± 1.2524
Regimen-related Distress - GDMDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.6 ± 0.8291.7 ± 0.714
Interpersonal Distress - AllDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.8 ± 1.110581.9 ± 1.2778
Interpersonal Distress - Type 1Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.7 ± 0.93351.9 ± 1.1230
Interpersonal Distress - Type 2Diabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.8 ± 1.26791.9 ± 1.3524
Interpersonal Distress - GDMDiabetes Distress Scale Not Collected in 2005Diabetes Distress Scale Not Collected in 20051.3 ± 0.6291.7 ± 0.814

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Regarding aspects of Screening Question responses - Table 14[a], only 20.3% of DDS 17 Questionnaires were undertaken in individuals who ‘screened negative’ [ie both Screening questions < 3] (versus 39.4% in 2010), suggesting compliance with our advice (Page 12 above).

A number [n=65], representing 10.4% of those who screened positive, did NOT have a DDS 17 Questionnaire administered, (versus 22.3% in 2010).

Those where Individual DDS Scores were ≥ 3 were far more likely seen where one or both Screening questions were scored ≥ 3 n= 353 versus n= 10 for Screening questions scored < 3. This was explored further in Table 14[b] for individuals 17 years and older.

Table 14[a] DDS 17 Questionnaire Data by Screening Question Score


Category2005 n = 1405

%
2005 n = 1405

N
2010 n
= 2131

%
2010 n
= 2131

N
2012 n
= 1892

N
2012 n
= 1892

%
DDS 17 Questionnaire DoneNot CollectedNot Collected49.8%106141.8%790
Screening questions ≥ 3 and DDS
17 Questionnaire Done
Not CollectedNot Collected60.1%63871.0%561
Screening questions < 3 and DDS
17 Questionnaire Done
Not CollectedNot Collected39.4%41820.3%160
Screening questions both Null and
DDS 17 Questionnaire Done
Not CollectedNot Collected0.5%58.7%69
Screening questions ≥ 3 and DDS
17 Questionnaire NOT Done
Not CollectedNot Collected22.3%18310.4%65
Individual DDS Scores ≥ 3 where
Screening questions ≥ 3
Not CollectedNot Collected48.4%39756.4%353
Individual DDS Scores ≥ 3 where
both Screening questions < 3
Not CollectedNot Collected4.2%441.1%10

We assessed DDS Data for those >17 years old [n=708 of the 714 total received]. Of these, there were 77.7% [n=550] where one or both DDS Screening questions was/were > 3 and 22.3% [n=158] where the DDS Screening Questions were both <3 but the 17 item Questionnaire was done anyway. This seems to have been a function of how some sites administered the overall survey – perhaps giving ‘everything’ to the patient to complete.

NOTE: Age > 17 years old was chosen arbitrarily to exclude younger individuals where a parent or guardian may have completed or assisted in completion of the DDS Questionnaire

We sought to compare the outcomes based on the 2 Screening Question findings. We found few individuals would be ‘missed’ if NOT screened on the basis of both Screening Questions being <3 – Table 14[b]. In Table 14[c], data for the 550 are assessed by Age Groups (with 2010 data for comparison).

Table 14[b] 2012 DDS Sub-scale Scores >3 by Screening Questions >3 versus <3

Total
Interpersonal Regimen Physician Emotional
550 Screening Questions
1 or 2 Score > 3
138
134
21561254
158 Screening Questions
BOTH Score < 3
2
4
32
4

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2010 DDS Sub-scale Scores >3 by Screening Questions >3 versus <3

Total
Interpersonal
RegimenPhysicianEmotional
626 Screening Questions
1 or 2 Score > 3
135
148
228
77273
404 Screening Questions
BOTH Score < 3
319715
11


Table 14[c] 2012 DDS Sub-scale Scores >3 by Screening Question >3 by Age Group

Age Group (years)n=Total [%]InterpersonalRegimenPhysicianEmotional
17 - 3511124 [21.6]
24
52752
36 - 5014241 [28.9]
42
561368
51 - 6520853 [25.5]
52
792397
66 +8920 [22.5]
16
281837

2010 DDS Sub-scale Scores >3 by Screening Question >3 by Age Group

Age Group (years)n=Total [%]Interpersonal**RegimenPhysicianEmotional**
17 - 3512713 [10.2]1748749
36 - 5013739 [28.5]37611975
51 - 6524366 [27.1]759040110
66 +11917 [14.3]19291139

** Note 2010 Interpersonal and Emotional column data were wrong – columns transposed (correct here).

As noted above (Page 12), in 2012 the DDS authors published a revision of DDS interpretation8, suggesting 3 patient subgroups:
  • little or no distress, <2.0;
  • moderate distress, 2.0–2.9;
  • high distress, ≥3.0.
An analysis using these cut-points has been undertaken for the data obtained in ANDIAB2 2010 as well as for ANDIAB2 2012. As can be seen in Table 14[d], a significant number of individuals fall into the ‘moderate distress, 2.0–2.9’ category, at least as many individuals, and in most instances, more than those with ‘high distress, ≥3.0.’

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Table 14[d] DDS Question Total & Sub-scale Score Categories by Diabetes Type


Category2010 n = 2131

n
2010 n = 2131

n < 2
2010 n = 2131

n >= 2 & < 3
2010 n = 2131

n >= 3
2012 n = 1892

n
2012 n = 1892

n < 2
2012 n = 1892

n >= 2 & < 3
2012 n = 1892

n >= 3
Total DDS Score - All1059608313138780395240145
Total DDS Score - Type 1334190115292301058144
Total DDS Score - Type 268138619210352627415498
Total DDS Score - GDM292441141031
Emotional Burden - All1060459311290780295217268
Emotional Burden - Type 1335130105100230697586
Emotional Burden - Type 2681304197180525214135176
Emotional Burden – GDM29205415753
Physician-related Distress – All1059866101927796437264
Physician-related Distress - Type 133428730172301912118
Physician-related Distress - Type 268153971715254295046
Physician-related Distress – GDM292801141400
Regimen-related Distress – All1060508314238778334214230
Regimen-related Distress - Type 133514311379230857174
Regimen-related Distress - Type 2681336194151524232141151
Regimen-related Distress – GDM292153141112
Interpersonal Distress – All1058719172167778486148144
Interpersonal Distress - Type 133523363392301385438
Interpersonal Distress - Type 267945310412252433192101
Interpersonal Distress - GDM292522141022

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4.10 Missing Data

With regard to Missing Data, Table 15 Page 19 provides details of the relatively minimal ‘Missing Data’ from ANDIAB2.

The Missing Data items are listed in increasing frequency. Overall Missing Data ranged from [n=5] 0.3% [Type of Diabetes] to [n=451] 49.4 % [Past Smoker - Stopped Other ( Past smokers only )], however 42.0% of the data items were less than 5% missing {[0-1] 10.1% [1-2] 10.1% [2-3] 4.4% [3-4] 13.0% [4-5] 4.4%]}, 13.0% were missing from 5-10% of records, 26.1% were missing from 10-15% of records and 18.8% were missing from 17.5-49.4% of records.

This is in contrast to ANDIAB2 2012, where there was less missing data:
53.7% of the data items were less than 5% missing {[0-1] 13.0% | [1-2] 3.7% | [2-3] 18.5% | [3-4] 14.8%]}, 24.1% were missing from 5-10% of records and 22.2% were missing from 10.3-22.5% of records.

This is in stark contrast to ANDIAB 2011 [N=8563] however, where only 13.9% of the data items were less than 20% missing. Further analysis of ANDIAB data showed:
Whilst some data items were almost 100% collected, overall Missing Data ranged from [n=24] 0.4% [Sex of Individual] to [n=2674] 57.8% [Retinal Camera]. There were 13.9% of the data items less than 20% missing {[0-5] 5.2% / [5-10] 3.5% / [10-15] 2.6% / [15-20] 2.6%]}, 27.8% were missing from 20-40% of records and 58.3% were missing from >40% of records [Table 24] 2.

Whilst much of the ANDIAB 2011 missing data relate to Fields such as Eye Data, which may not be readily available to the Clinician, there would appear no doubt that the ANDIAB2 completeness of data collection is a testament to the diligence of those who participated [including the individuals themselves in completing the EQ-5D and DDS components].

[See Appendix 7 for all missing data graphs].

Sites were given an opportunity to supply any missing data and to validate questionable data. Table 15[a] shows the Missing ‘Vital’ Data items obtained by requesting their provision from sites – with substantial improvements, (except ‘Diagnosis Year’ - only 42.4% obtained, and ‘Insulin Since’ (see ** below Table). As can be seen from Table 15[a], this process reduced the missing data in five of the seven elements sought, from just over a half - to over 83% {53.1-83.3%}.

It was only necessary in a few instances to review data items that were not possible (as indicated on Page 3) [eg ‘Management Method’ not Insulin, but ‘Insulin Since’ not null - in which case the ‘Insulin Since’ date was removed and considered missing in the pooled database, prior to final data analysis].

There were sixty four duplicate data sheets provided – and the extra ones were removed.

Table 15[a] Missing Data Obtained from Sites

Data ItemInitially
Missing
n =
Initially
Missing
[%]
Still Missing
n =
Still Missing
[%]
Obtained
[%]
Date of Birth492.5%231.2%53.1%
Sex502.6%90.5%82.0%
Initial Visit502.6%221.2%56.0%
Diagnosis Year331.7%191.0%42.4%
Diabetes Type301.5%50.3%83.3%
Diabetes Therapy844.3%170.9%79.8%
Insulin Since **472.4%482.5%-2.1%

**Note: ‘Insulin Since’ Data got worse because when sites updated Diabetes Therapy as Insulin or Insulin & Tablets, they did NOT also provide the year of Insulin commencement and we did not go back to sites a second time to seek this information.

Table 15 Missing Data

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'Field (Condition)'
n 2010'
% 2010'
n 2012'
% 2012'
Type of Diabetes
5
0.2
5
0.3
Sex of Individual
9
0.4
9
0.5
Smoker: currently
58
2.7
9
0.5
Smoking Status
58
2.7
10
0.5
DDS 17 Questionnaire Done
21
2.6
4
0.6
Medications - How many times forget medications? (Only Patients who forget)
#
#
3
0.7
Management method
8
0.4
17
0.9
Duration
12
0.6
19
1.0
Year of diagnosis
12
0.6
19
1.0
Complementary Therapy - Told Dr or Educator of use ( Only Patients who are on Complementary Therapy )
5
0.8
6
1.0
Initial Visit
7
0.3
22
1.2
Age
14
0.7
23
1.2
Date Of Birth
7
0.3
23
1.2
Vaccination – Flu in past 12 months
115
5.4
32
1.7
Physical Activity Sufficiency Status
83
3.9
45
2.4
Vaccination- Pneumococcal in past 12 months
130
6.1
50
2.6
Tried to stop smoking ( Current Smokers Only )
6
2.2
8
2.9
Attended Diabetes Educator
60
2.8
60
3.2
Attended Diabetes Specialist
54
2.5
60
3.2
Attended Podiatrist
52
2.4
61
3.2
Attended Dentist
75
3.5
62
3.3
Diet - Difficulties following prescribed diet?
#
#
62
3.3
Attended Dietitian
72
3.4
63
3.3
Attended Psychologist
72
3.4
64
3.4
Attended Ophthalmologist
70
3.3
70
3.7
Attended Social Worker
92
4.3
72
3.8
Medications - Ever forget to take medications?
#
#
78
4.1
Insulin start year (Only patients using Insulin)
34
2.4
48
4.2
Attended Exercise Physiologist
80
3.8
83
4.4
Attended Optometrist
70
3.3
101
5.3
Medications - Usually take all your medications?
#
#
107
5.7
Complementary Therapy or dietary supplement used
71
3.3
114
6.0
Medications – Do you stop taking when feeling better?
#
#
116
6.1
Medications – Do you stop taking when feeling worse?
#
#
117
6.2
Indigenous - ATSI
156
7.3
145
7.7
DVA Patient
178
8.4
158
8.4
LipoHypertrophy Present
119
5.6
170
9.0
LipoAtrophy Present
148
6.9
188
9.9
DDS - Emotional Burden
183
22.3
70
11.2
DDS - Physician-related Burden
184
22.4
70
11.2
DDS - Total DDS Score
184
22.4
70
11.2
Interpreter Required
275
12.9
212
11.2
DDS - Regimen-related Burden
183
22.3
71
11.3
DDS - Interpersonal Distress
185
22.5
71
11.3
BCD - Brief case-find for depression (Calculated)
205
9.6
236
12.5
BCD - Had restless or disturbed nights
210
9.9
238
12.6
Past Smoker - Just Stopped ( Past smokers only )
#
#
89
12.6
BCD - Feeling unhappy or depressed
208
9.8
240
12.7
BCD - Felt unable to overcome difficulties
212
9.9
240
12.7
NDSS Member
157
7.4
240
12.7
On antidepressants
214
10.0
242
12.8
BCD - Dissatisfied with their way of doing things
219
10.3
246
13.0
Psychiatric treatment/counselling - current
223
10.5
246
13.0
Psychiatric treatment/counselling - previous
222
10.4
247
13.1
Pregnant: Currently
201
9.4
255
13.5
QOL - Own Health State Rating (0-100)
282
13.2
271
14.3
DDS – Screening Scale Q1
257
12.1
332
17.5
DDS – Screening Scale Q2
258
12.1
332
17.5
Glycated Haemoglobin
451
21.2
350
18.5
Diet - Too hard to count carbohydrates? ( Only Patients who are type 1 )
#
#
103
25.6
Past Smoker - Nicotine ( Past smokers only )
#
#
315
44.6
Past Smoker - Medication ( Past smokers only )
#
#
317
44.8
Past Smoker - Hypnosis ( Past smokers only )
#
#
328
46.4
Past Smoker - Acupuncture ( Past smokers only )
#
#
336
47.5
Diet - Not enough time to prepare healthy meals?
#
#
905
47.8
Diet - It costs too much to eat well?
#
#
909
48.0
Diet - Don't know what best foods are to eat?
#
#
915
48.4
Diet - Eat out a lot and find it hard to eat well?
#
#
916
48.4
Past Smoker - Stopped Other ( Past smokers only )
#
#
349
49.4

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# means that this data item was not collected that year

4.11 Questionnaire Results:



Two Questionnaires were distributed as in ANDIAB 2011 [See Appendix 4]:
  • Questionnaire 1 relates to the data collection process,
[This was sent to each Site after their data had been received];
  • Questionnaire 2 relates to comments on the Individual Site Reports,
[This was sent to each Site with their Report – however insufficient responses have been received at the time of preparation of this report to be included].

Table 16 details the results of assessment of the Questionnaire 1 Lickert Scale responses from participants to the specific questions related to the data collection project. This is a 1 to 5 scale {1[Poor]-5[Good]} 3=Midpoint, and data are presented as Mean  (SD).

Clearly ‘Time to complete the Form’ was of concern for most (rating 2.9), but pleasingly all other aspects of the Project were rated relatively highly (3.2 – 3.8) amongst the 29 responses received.


In addition, the free text responses to questions and to other items could be reviewed individually, and utilised to refine the data collection instrument and reporting process, to assist in running future data collections – should they occur - as they have in the past.

Table 16 Questionnaire 1 Responses

Questionnaire 1 [Re Data Collection Process] - Lickert Scale {1[Poor]-5[Good]} 3=Midpoint Mean (SD)

2010 [ n = 19 ]
2012 [ n = 29 ]
Information Package/Letters
3.6 + 1.1
3.6 + 1.0
Data Definitions Form
3.7 + 1.1
3.6 + 1.1
Format (layout of data items)
3.4 + 1.1
3.2 + 1.3
Ease of completion
3.1 + 0.9
3.3 + 1.1
Time to complete the Form
2.2 + 1.1
2.9 + 1.0
Diabetes Distress Scale Calculator
4.1 + 1.3
3.8 + 1.6

6. Metadata Online Registry [‘METeOR’] - Diabetes (clinical) Data Set Specification. [see AIHW website]: AIHW Metadata Online Registry
7. Assessing Psychosocial Distress in Diabetes Development of the Diabetes Distress Scale. William H. Polonsky, Lawrence Fisher, Jay Earles, R. James Dudl, Joel Lees, Joseph Mullan, Richard A. Jackson. Diabetes Care 28:626–631, 2005.
8. When Is Diabetes Distress Clinically Meaningful? Establishing cut points for the Diabetes Distress Scale. Lawrence Fisher, Danielle M Hessler, William H Polonsky, Joseph Mullan. Diabetes Care 35:259-264, 2012.
9. DiabCo$t Australia: Assessing the burden of Type 2 Diabetes in Australia, Diabetes Australia, Canberra, December, 2003. Colagiuri S, Colagiuri R, Conway B, Grainger D, Davey P.