Diabetes distress in young adults with early‐onset Type 1 diabetes and its prospective relationship with HbA_1cand health status

Abstract

Aim This study aimed to determine cross‐sectional relationships between diabetes distress and health‐related variables, and prospective associations between diabetes distress and future glycaemic control (HbA1c) and health status among young adults with early‐onset Type 1 diabetes. Methods Data were collected from a nationwide cohort study of adults whose Type 1 diabetes onset occurred from 0 to 4 years of age during 1993–2002. Questionnaire surveys were conducted in 2012–2013 and 2015–2016 (N = 584). Diabetes distress was assessed via the Problem Areas in Diabetes (PAID) scale (0–100 points), depressive symptoms via the Patient Health Questionnaire‐9 (PHQ‐9) and health status via the 12‐Item Short Form Health Survey (SF‐12) questionnaire. Multivariable linear regression analyses were applied to cross‐sectional and longitudinal data. Results In the cross‐sectional analyses, higher PAID scale total scores (representing higher distress levels) were observed in women than in men and in participants with more severe depressive symptoms. PAID scores were lower in individuals with better physical and mental health. A 1 mmol/mol increase in HbA1c was associated with a 0.28‐point increase [95% confidence interval (95% CI) 0.20, 0.36] in diabetes distress. In longitudinal analyses adjusting for age, sex, socio‐economic index and HbA1c at baseline, a 10‐point higher PAID score at baseline was associated with a 1.82 mmol/mol higher HbA1c level (95% CI 0.43, 3.20) and a 2.48‐point lower SF‐12 mental health score (95% CI −3.55, −1.42) three years later. Conclusions The cross‐sectional and longitudinal analyses results suggest that diabetes distress impairs health‐related outcomes in young adults with early‐onset diabetes.

Increased risk of impaired treatment satisfaction among girls/women and young people with suboptimal HbA1c: Results of a nationwide type 1 diabetes study

“…The participants were 11 to 27 years old and had a type 1 diabetes duration of 10 years or longer in 2015-2016 (n = 575). Factors that were potentially associated with poor treatment satisfaction (moderate, poor or very poor) compared to the reference group (very good or good treatment satisfaction) were analyzed by log binomial regression adjusted for sex and age group.Results: In 2015In -2016In -2019, 26% (33%) of the respondents rated their diabetes treatment/consultation as "very good", 53% (46%) as "good", and 20% (21%) as "poor". Based on the 2018-2019 data, girls/women had an increased risk of poor treatment satisfaction (RR girls/women : 1.64 (1.10; 2.44), p = 0.016).…”

“…Results: In 2015In -2016In -2019, 26% (33%) of the respondents rated their diabetes treatment/consultation as "very good", 53% (46%) as "good", and 20% (21%) as "poor". Based on the 2018-2019 data, girls/women had an increased risk of poor treatment satisfaction (RR girls/women : 1.64 (1.10; 2.44), p = 0.016).…”

The cognitive and psychological effects of living with type 1 diabetes: a narrative review

“…Fewer studies on diabetes distress have been conducted in emerging adults specifically, and reviews are lacking. Across studies, prevalence rates of psychological (diabetes) distress vary from 12% to 60% . It should be kept in mind that both anxiety and diabetes distress are strongly correlated with depressive symptoms, so those with depressive symptoms are likely to experience symptoms of anxiety or distress as well .…”

Psychische Komorbiditäten bei Jugendlichen und jungen Erwachsenen mit Typ-1-Diabetes

“…Circa 15 % der Kinder und Jugendlichen mit T1DM sind von einer psychischen Komorbidität beeinträchtigt [7]. Bestehende komorbide psychische Belastungen und Störungen während der Adoleszenz können sowohl akute negative Auswirkungen auf den Verlauf der Diabetesbehandlung und die Lebensqualität als auch langfristig auf die Diabetesergebnisse im Erwachsenenalter haben [15][16][17]. Ein frühzeitiges Erkennen und eine angemessene Intervention bei einer vorliegenden psychischen Belastung und Störung sind deshalb von großer Relevanz [18][19][20].…”