Diabetes distress is linked with worsening diabetes management over time in adults with Type 1 diabetes
D M Hessler, L Fisher, W H Polonsky, U Masharani, L A Strycker, A L Peters, I Blumer, V Bowyer, D M Hessler, L Fisher, W H Polonsky, U Masharani, L A Strycker, A L Peters, I Blumer, V Bowyer
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.
Conflict of interest statement
Competing interests
None declared. Lawrence Fisher: consultant or advisory board with Roche Diagnostics, Elli Lilly Abbott Diabetes Care; William Polonsky: consultant or advisory board with Sanofi, Novo Nordisk, Eli Lilly, Dexcom, Abbott, Johnson & Johnson, Boehringer Ingelheim, Takeda, Roche; Anne Peters: consultant or advisory board with Amgen, Abbott Diabetes Care, Becton Dickinson, Biodel, Bristol Myers Squibb/AstraZeneca, Janssen, Lexicon, Eli Lilly, Medtronic Minimed, Novo Nordisk, OptumRx, Sanofi, Takeda, Thermalin. Speakers Bureau – Bristol Myers Squibb/AstraZeneca, Novo Nordisk, Janssen; Ian Blumer: consultant to or advisory board with Animas, Bayer, BD Diabetes, BMS/AZ, Eli Lilly, Janssen, Medtronic, Merck, Novo Nordisk, Roche, Sanofi.
© 2017 Diabetes UK.
Source: PubMed