Diabetes Burnout Among the Elderly With Type 2 Diabetes
Abstract
Diabetes mellitus (DM) is one of the most prevalent chronic diseases among the elderly, often leading to complications, dependency, and psychosocial burdens. Globally, over 20% of adults aged ≥65 years live with DM, and in Indonesia, its prevalence among the elderly reaches 19.2%. Despite this high burden, limited studies have addressed diabetes burnout (DB) in elderly patients, particularly within cultural contexts where family caregivers play a central role. This study aimed to explore the level of burnout in the elderly with DM and identify contributing factors. A descriptive-analytical quantitative design was applied involving 176 elderly DM patients registered in the Prolanis program at Semarang Regency Health Center, selected using purposive sampling. Data were collected using the Diabetes Burnout Syndrome (DBS) questionnaire and analyzed with descriptive statistics, chi-square test, and logistic regression. Findings showed that most participants were female, had a high school education, and had lived with DM for less than five years. Gender and education had a significant influence on DBS scores (p < 0.005). Burnout was higher among women, patients with DM >5 years, and those with a bachelor’s degree. Education emerged as the most influential factor, with higher education levels associated with an 11.76-fold increased risk of burnout (p < 0.001). Conclusion: Education plays a dominant role in shaping burnout among the elderly with DM. Interventions tailored to demographic characteristics, disease duration, and employment status, supported by social support and health education, are crucial for reducing burnout and enhancing chronic care.
References
WHO. Diabetes [Internet]. WHO. 2024. Available from: https://www.who.int/health-topics/diabetes#tab=tab_1
American Diabetes Association. Understanding diabetes and mental health [Internet]. ADA. 2022 [cited 2023 Feb 1]. Available from: https://diabetes.org/healthy-living/mental-health
Abdoli S, Miller-Bains K, Burr EM, Smither B, Vora A, Hessler D. Burnout, distress, and depressive symptoms in adults with type 1 diabetes. J Diabetes Complications [Internet]. 2020;34(7):107608. Available from: https://doi.org/10.1016/j.jdiacomp.2020.107608
Kalra S, Kapoor N JJ. The psychosocial impact of diabetes in aging populations. Diabetes Ther. 2022;13(7):1341–1354.
Trento M, Gamba S, Gentile S, Miselli V, Tomalino M et al. Diabetes burnout: an overlooked challenge in older adults with type 2 diabetes. BMC Public Health. 2023;23(1124).
Liu SY, Huang J, Dong QL, Li B, Zhao X, Xu R, et al. Diabetes distress, happiness, and its associated factors among type 2 diabetes mellitus patients with different therapies. Medicine (Baltimore) [Internet]. 2020;99(11):1–8. Available from: 10.1097/MD.0000000000018831
Yang F, Pang JS, Cheng WJY. Self-Care Adherence and Psychological Functioning of Older Patients with Type 2 Diabetes: Effects of Persuasion, Social Pressure, and Self-Efficacy. J Clin Psychol Med Settings. 2016;23(4):389–401.
Sari RN, Mulyati T SC. Diabetes distress and quality of life among adults with type 2 diabetes mellitus in Indonesia. BMC Endocr Disord. 2022;22(31).
Kontoangelos K, Raptis A, Lambadiari V, Economou M, Tsiori S, Katsi V, et al. Burnout Related to Diabetes Mellitus: A Critical Analysis. Clin Pract Epidemiol Ment Heal. 2022;18(1):1–12.
Study O, Esen SA. Fatigue and depression in elderly patients with poorly controlled diabetes. Medicine (Baltimore). 2022;45(101):1–7.
Kalra S, Jena BN, Yeravdekar R. Emotional and psychological needs of people with diabetes. Indian J Endocrinol Metab. 2018;22(5):696–704.
Tan SY, Magarey J, Chee SS, Lee LF LT. Self-care, self-efficacy, depression and distress in patients with type 2 diabetes in Singapore. BMC Public Health. 2020;20(1):1–12.
Mirzazadeh-qashqaei F. The relationship between and coping strategies in patients with type 2 diabetes mellitus. J Res Nurs. 2023;28(3):259–69.
Dinas Kesehatan Provinsi Jawa Tengah. Cakupan Pelayanan Kesehatan Usia Lanjut Menurut Kabupaten Kota Tahun 2023 [Internet]. Portal Data. 2024 [cited 2024 Jul 12]. Available from: data.jatengprov.go.id/de/dataset/cakupan-pelayanan-kesehatan-usia-lanjut-menurut-kabupaten-kota-tahun-2023?
Dinkes Jateng. Profil Kesehatan Provinsi Jawa Tengah Tahun 2023. 2023.
Abdoli S, Miller-Bains K, Fanti P, Silveira MSVM, Hessler D. Development and validation of a scale to measure diabetes burnout. J Clin Transl Endocrinol [Internet]. 2021;23:100251. Available from: https://doi.org/10.1016/j.jcte.2021.100251
Huang LC, Lin CL, Chang YT, Chen RY, Bai CH. Gender Impact on Diabetes Distress Focus at Medical Communication Concerns, Life and Interpersonal Stress. Int J Environ Res Public Health. 2022;19(23).
Zapater-fajarí M, Crespo-sanmiguel I, Pulopulos MM, Colman R. Resilience and Psychobiological Response to Stress in Older People : The Mediating Role of Coping Strategies. Front Aging Neurosci. 2021;13:1–15.
Auttama N, Kumar R, Somrongthong R, Tonchoy P, Panta P. Stress and associated risk factors among the elderly : a cross-sectional study from rural area of Thailand [ version 2 ; peer review : 2 approved ] Previously titled : Stress and associated risk factors among the elderly : a cross-sectional study from rur. Natl Libr Med. 2020;8(655):1–14.
Carla M Prado, John A Batsis, Lorenzo M Donini, M. Christina Gonzles MS. Sarcopenic obesity in older adults: a clinical overview. Nat Rev Endocrinol. 2024;20(5):261–77.
Ummu Muntamah, Puji Purwaningsih, Hardhono Susanto , AnnastasiaEdiati DL. A Qualitative Study Of Perceptions And Living Experiences With The Diagnosis of Diabetes Mellitus. J Ilmu Keperawatan Komunitas [Internet]. 2023;6(2):1–19. Available from: https://journal.ppnijateng.org/index.php/jikk/article/view/2252/940
Halim M, Halim A. Diabetes & Metabolic Syndrome : Clinical Research & Reviews The effects of in fl ammation , aging and oxidative stress on the pathogenesis of diabetes mellitus ( type 2 diabetes ). Diabetes Metab Syndr Clin Res Rev [Internet]. 2019;13(2):1165–72. Available from: https://doi.org/10.1016/j.dsx.2019.01.040
Zeng Q yue, Qin Y, Shi Y, Mu X yu. Systemic immune-in fl ammation index and all-cause and cause- speci fi c mortality in sarcopenia : a study from National Health and Nutrition Examination Survey 1999-2018. Front Immunol. 2024;4(15):1–12.
Mishra S, Rout SS, Mohanty P, Mohapatra N. Prevalence of Commorbidity among Elderly Hospitalized Patients in A Tertiary Care Centre of Odisha. Int J Acad Med Pharm. 2023;5(6):226–30.
Ali D, Tencerova M, Figeac F, Kassem M, Jafari A. The pathophysiology of osteoporosis in obesity and type 2 diabetes in aging women and men : The mechanisms and roles of increased bone marrow adiposity. Front Endocrininol. 2022;13(981487):1–16.
Muntamah Ummu, Susanto Hardhono, Ediati Annastasia DL. Efektifitas Model Intervensi Diabetes Distress Management “ASSESS” Berbasis Telehealth Terhadap Kualitas Hidup Penderita Diabetes Melitus Tipe 2 (Kajian pada parameter JCS, DDS-17 dan SDSCA pada penderita DM Tipe 2) [Internet]. University of Diponegoro; 2024. Available from: https://eprints2.undip.ac.id/id/eprint/24039/
Made Dian Kusumawati, Kusnanto BP. Comparison of the Effectiveness of Mindfulness Based Intervention on Diabetes Resilience Training on Diabetes Burnout Syndrome and Glycemic Control in Type 2 Diabetes Mellitus Patients. J Penelit Kesehat Suara Forikes. 2022;13(1):24–33.
Ilmiah J, Indonesia N, Shera SD, Hakam M, Widayati N, Keperawatan F, et al. The Relationship between Self-Empowerment and Emotional Intelligence of Type 2 Diabetes Mellitus Patients at RSD dr. Soebandi Jember. J Ilm Ners Indones. 2024;5(2):110–9.
Bi Y, Zhang L, Li X, Kan Y, Li S, Zou Y, et al. Contributing factors of fatigue in patients with type 2 diabetes: A systematic review. Psychoneuroendocrinology [Internet]. 2021;130:105280. Available from: https://doi.org/10.1016/j.psyneuen.2021.105280
Kuo, Hsuan-Ju, Alexandra A. García CYH. Impact of Fatigue and Its Influencing Factors on Diabetes Self-Management in Adults With Type 2 Diabetes: A Structural Equation Modeling Analysis. Sage J. 2023;49(6).
Bhatt PP, Sheth MS. Comparison of fatigue and functional status in elderly type 2 diabetes patients versus age and gender matched individuals. Aging Med. 2024;7:84–9.
Abdoli S, Miller-Bains K, Burr EM, Smither B, Vora A, Hessler D. Burnout, distress, and depressive symptoms in adults with type 1 diabetes. J Diabetes Complications [Internet]. 2020;34(7):107608. Available from: https://doi.org/10.1016/j.jdiacomp.2020.107608
Li S, Fang L, Lee A, Hayter M, Zhang L, Bi Y, et al. The association between diabetes-related distress and fear of hypoglycaemia in patients with type 2 diabetes mellitus: A cross-sectional descriptive study. Nurs Open. 2021;8(4):1668–77.
Lehmann G, Ziebell P, Schmitt A, Kulzer B, Hermanns N, Ehrmann D. Explaining improvement in diabetes distress: a longitudinal analysis of the predictive relevance of resilience and acceptance in people with type 1 diabetes. Acta Diabetol [Internet]. 2024;61(2):151–9. Available from: https://doi.org/10.1007/s00592-023-02180-2
Gupta S, Solomon L, Jacob JJ. Diabetic distress and work-related stress among individuals with type 2 diabetes mellitus. Clin Diabetol. 2022;11(1):11–4.
Knowles SR, Apputhurai P, O’Brien CL, Ski CF, Thompson DR, Castle DJ. Exploring the relationships between illness perceptions, self-efficacy, coping strategies, psychological distress and quality of life in a cohort of adults with diabetes mellitus. Psychol Heal Med [Internet]. 2020;25(2):214–28. Available from: https://doi.org/10.1080/13548506.2019.1695865
Copyright (c) 2025 Ummu Muntamah , Dewi Siyamti, Medina Sianturi
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
