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 HbA_1c (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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BDI Monthly Events

June 5 - 8: It will be a busy time at the American Diabetes Association’s 85th Scientific Sessions (New Orleans, LA), with new projects to be developed, old friends to see, and much to learn. Dr. Polonsky, BDI President, will serve a co-author on four poster presentations

May 13: 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.

August 14 - 16. Taking Control of Your Diabetes (TCOYD) will be hosting the in-person ONE event, an amazing weekend experience here in San Diego for more than 500 people with type 1 diabetes and their loved ones. Dr. Polonsky is honored to be one of the presenters, and we will hope to see many of you there. There are still a few spaces left, so if you’d like to know more, please visit

On October 24, BDI will host a live, one-day, CME workshop: Engaging the Disengaged: Innovative Strategies for Promoting Behavior Change in Diabetes. Run by Dr. Polonsky (BDI President) and Dr. Guzman (BDI Clinic Director), Participants will deepen their skills in recognizing and addressing common barriers to effective self-care and cardiometabolic medication initiation and maintenance, while fostering respectful, stigma-free clinical encounters.