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

作者：Hessler D M; Fisher L; Polonsky W H; Masharani U; Strycker L A; Peters A L; Blumer I; Bowyer V

来源：Diabetic Medicine, 2017, 34(9): 1228-1234.

DOI：10.1111/dme.13381

AimTo determine the cross-sectional and longitudinal associations between diabetes distress and diabetes management.
MethodsIn a non-interventional study, 224 adults with Type 1 diabetes were assessed for diabetes distress, missed insulin boluses, hypoglycaemic episodes, and HbA(1c) at baseline and 9 months.
ResultsAt baseline, greater distress was associated with higher HbA(1c) 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 HbA(1c). In supplementary analyses, neither depression symptoms nor a diagnosis of major depressive disorder was associated with missed insulin boluses, HbA(1c) or hypoglycaemic episodes in cross-sectional or longitudinal analyses.
ConclusionsSignificant 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 HbA(1c) 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.

• 出版日期2017-9