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Diabet Med. 2017 Sep;34(9):1228-1234. doi: 10.1111/dme.13381. Epub 2017 Jun 18.

Diabetes distress is linked with worsening diabetes management over time in adults with Type 1 diabetes.

Author information

1
Department of Family & Community Medicine, San Francisco, USA.
2
Behavioral Diabetes Institute, San Francisco, USA.
3
Department of Medicine, University of California-San Francisco, San Francisco, USA.
4
Oregon Research Institute, Eugene, USA.
5
University of Southern California, Los Angeles, USA.
6
Charles H. Best Diabetes Centre, Ontario, Canada.

Abstract

AIM:

To determine the cross-sectional and longitudinal associations between diabetes distress and diabetes management.

METHODS:

In a non-interventional study, 224 adults with Type 1 diabetes were assessed for diabetes distress, missed insulin boluses, hypoglycaemic episodes, and HbA1c at baseline and 9 months.

RESULTS:

At baseline, greater distress was associated with higher HbA1c and a greater percentage of missed insulin boluses. Longitudinally, elevated baseline distress was related to increased missed insulin boluses, and decreases in distress were associated with decreases in HbA1c . In supplementary analyses, neither depression symptoms nor a diagnosis of major depressive disorder was associated with missed insulin boluses, HbA1c or hypoglycaemic episodes in cross-sectional or longitudinal analyses.

CONCLUSIONS:

Significant cross-sectional and longitudinal associations were found between diabetes distress and management; in contrast, no parallel associations were found for major depressive disorder or depression symptoms. Findings suggest that elevated distress may lead to more missed insulin boluses over time, suggesting a potential intervention target. The covarying association between distress and HbA1c points to the complex and likely interactive associations between these constructs. Findings highlight the need to address distress as an integral part of diabetes management in routine care.

PMID:
28498610
PMCID:
PMC5561505
DOI:
10.1111/dme.13381
[Indexed for MEDLINE]
Free PMC Article

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