Diabetes distress and self-management in primary care in Singapore: explorations through illness perception

Janice Quek, Grace Tan, Kokkwang Lim, Chee Khong Yap, Meiyin Wong, Jiaying Soon


Background: Singapore was recently ranked the second highest in the percentage of diabetic individuals among developed countries’ populations. This study explored possible associations among type 2 diabetes mellitus (T2DM) patients’ perception of having this condition (illness perception), diabetes-related distress, and diabetes self-management with a view to understanding potentially useful emphases in health education and counselling for these patients in primary health care.

Methods: A cross-sectional sample of 75 adults diagnosed with T2DM at five primary care clinics under National Healthcare Group Polyclinics completed three research questionnaires in English and Mandarin which assessed the participants’ perception of their own diabetic condition, experience of diabetes distress, and self-management behaviour.

Results: Illness perception has specific dimensions (identity, consequence, and emotional representation) that correlated with specific aspects of diabetes distress (emotional burden, interpersonal distress, regimen distress, and overall diabetes distress). Further, overall diabetes distress correlated negatively with dietary control, physical activity, and overall self-management.

Conclusions: Patients with TSDM may benefit most from health education and guidance that aim to reduce both their perception of diabetes’ impact on their lives and emotional reactivity in managing their diabetic condition.


Emotional adaptation, Perception, Primary health care, Self-care, Singapore, Type 2 diabetes mellitus

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