How Might We Tell if Advances in Diabetes Care and Technology are Helping People to Feel Less Constrained? Introducing the Diabetes Constraints Scale

Authors: William Polonsky, Emily Soriano, Lisa Strycker, Lawrence Fisher.

Abstract

Background: Recent advances in diabetes care and technology, such as real-time continuous glucose monitoring, can help people live more freely, with more flexibility and fewer constraints, thereby enhancing quality of life (QOL). To date, there has been no validated means for measuring this key psychological dimension. We developed the Diabetes Constraints Scale (DCS) to assess perceived constraints pertaining to diabetes self-management.

Methods: Six items were developed from qualitative interviews (20 adults with type 2 diabetes [T2D], 8 adults with type 1 diabetes [T1D]). Items were included in one study with T2D adults (N = 458) and one with T1D adults (N = 574). Scale reliability was analyzed for each study using exploratory factor analyses. Associations between DCS and key psychosocial and glycemic variables were assessed.

Results: In both studies, factor analyses revealed a single factor, with adequate internal reliability (Cronbach’s alpha >.80). Both studies demonstrated significant associations in the expected direction between DCS and overall well-being, diabetes-specific QOL, and diabetes distress (all P < .001). In both studies, DCS was positively linked with the number of missed insulin boluses and the frequency of severe hypoglycemic episodes (T1D both P < .001; T2D both P < .005) and-in the T1D group only-with HbA1c (P < .001).

Conclusions: The DCS is a reliable and valid method to determine the degree to which adults with diabetes feel constrained or limited by the disease. It may serve as a useful tool for assessing how new interventions can help individuals feel freer in the face of the demands of diabetes.

Source: https://pubmed.ncbi.nlm.nih.gov/39726263/

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March 12Case Consultation Meeting
March 12: BDI hosts the San Diego-wide, monthly case consultation meeting (for mental health professionals working in the field of diabetes). Contact us at [email protected] if you are in the greater San Diego area and would like further information about this program.
March 19-22International Conference
18th International Conference for ATTD (Advanced Technologies and Treatments for Diabetes) in Amsterdam, Dr. Polonsky (BDI President) has three presentations.
March 19Type 2 Presentation
On March 19, Dr. Polonski will present CGM is Wonderful, But… at the Roche-sponsored symposium, “Translating the Power of Prediction into Diabetes Management”, and Insulin Therapy Experience: Considering the Needs of People Living with Diabetes (with Professor Cukierman-Yaffe) at the Sanofi-sponsored symposium, Confidence and Simplicity in Diabetes Management”. https://attd.kenes.com/
March 20Type 2 Presentation
On March 20, Dr. Polonski will present Improved Patient- and Physician-Reported Outcomes with IGlarLixi When Switching From Premixed Insulin in People with Type 2 Diabetes: The Soli-Switch Study. https://cslide.ctimeetingtech.com/attd25/attendee/confcal/session/calendar/2025-03-20