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One unanticipated finding was that participants who had an education level of completion of high school or above, reported higher levels of distress in the domain of physician and emotional distress. This outcome is contrary to that of Aljuaid et al 15 and Islam et al 17 who found that a lower education level was associated with more distress. This might suggest that patients who have a higher education, may need to discuss the aspects of the treatment process in more detail.

Research was conducted in Ho Chi Minh City which is one of the largest and most crowded cities in Vietnam, the number of patients in outpatient departments are large and policies state that each physician is required to see 65 patients per day. In our study, the timescale of diabetes over 5 years reported higher distress in relation to total distress. However, the finding in Islam M. This finding is consistent with Fisher et al who confirmed that diabetes distress was a bidirectional relationship with poorer glycemic control in patients with Type 2 Diabetes.

Additionally, diabetes patients with negative psychological changes could experience negative impacts in metabolic control. Therefore, understanding the psychological problems and the changes in glycemic control levels should be considered.

Some limitations of this study included the fact that there is limitation of a cross-sectional study in extracting the cause—effect relationship between demographic characteristics of patients and distress was considered.

Therefore, combining the evaluation for distress as part of regular procedures into diabetes care, and recommending physicians apply a comprehensive approach for diabetes management, is necessary.

The authors would like to thank the nurse of the Endocrinology Departments as well as the patients for the time and effort they devoted to this study. The data used to support this study are available from the first author upon request. All authors made substantial contributions to conception and design, acquisition of data, analysis, and interpretation of data, took part in revising the article critically for important intellectual content, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

The authors declare they have no conflicts of interest for this work. National Center for Biotechnology Information , U. Diabetes Metab Syndr Obes. Published online Feb Author information Article notes Copyright and License information Disclaimer.

Received Dec 15; Accepted Jan This work is published and licensed by Dove Medical Press Limited. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4. This article has been cited by other articles in PMC. Abstract Background Diabetes-related distress DRD refers to the condition of negative emotion as a result of living with diabetes and the burden of self-care.

Results A total of participants, who were mainly over 60 years old Conclusion A high rate of distress exists in people with diabetes. Keywords: diabetes, diabetes distress scale, distress, Vietnam. Introduction Diabetes, which is one of the most common chronic non-communicable diseases globally, is recorded as the seventh leading cause of death worldwide. Methods Study Population A cross-sectional study was collected between April and November at the outpatient departments of three district hospitals of Ho Chi Minh City.

Method of Analysis A 6-point Likert scale ranging between 1 not a problem and 6 a very serious problem was used to assess the score of each item. Ethical Approval Our research complied with the Declaration of Helsinki. Results Baseline Characteristics of Participants As shown in Table 1 , a total of people with DM participate and were predominately female See this announcement for details on changes for public sector customers.

Information about how to enroll and get started in the Cloud Solution Provider program is on the Microsoft partner website. For partners, also see this blog post referring to the expanding opportunities for partners in the Cloud Solution Provider program. Please contact your current licensing partner and they will be able to help you through this change. Microsoft Open License program changes This is the first of two articles about the Open License program. Microsoft Open License program changes Learn about how we're simplifying licensing through the new commerce experience Update December 17, The below changes will also apply to public sector—education, government, and nonprofit—customers.

Talk to your software reseller to find out if they are a Cloud Solution Provider or find a partner. For alternatives, talk to your current licensing partner. If you have Software Assurance coverage through the Open License program: Your Software Assurance term, including benefits, will continue until its expiration, even if the expiration is after December 31,