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

Authors: Hessler DM, Fisher L, Polonsky WH, Masharani U, Strycker LA, Peters AL, Blumer I, Bowyer V

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 HbA_1c at baseline and 9 months.

Results: At 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.

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 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.

Source: https://pubmed.ncbi.nlm.nih.gov/28498610/

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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.