Adults with type 1 diabetes have ‘moderate’ diabetes distress even with CGM use
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BALTIMORE — Adults with type 1 diabetes experience diabetes distress even with the use of continuous glucose monitoring, according to findings presented at the Association of Diabetes Care & Educational Specialists Annual Conference.
“One of the benefits of CGM is that it helps to streamline diabetes management, which may help to make daily diabetes management easier,” Katherine S. Chapman, BA, research manager at T1D Exchange, and Caitlin S. Kelly, PhD, a research scientist at T1D Exchange, told Healio. “We have some very preliminary evidence where we see that regimen distress scores are lower than the emotional burden. But past research is mixed about whether CGM use means people experience less diabetes distress. It makes sense to us that the difficulty of living with diabetes — the emotional burden of having a chronic illness that invades every part of your daily life — would still be difficult even if some aspects of management are made easier through CGM.”
Researchers recruited 244 adults with type 1 diabetes who used a Dexcom CGM from the T1D Exchange Registry to complete a brief online survey (mean age, 40.8 years; 78.3% women; 94.7% white). Participants completed the two-item Diabetes Distress Scale, which asks participants if they are feeling overwhelmed by the demands of living with diabetes and feeling as if they are often failing with their diabetes regimen. Researchers compared the results from the two-item survey with the emotional burden and regimen distress subscales of the 17-time Diabetes Distress Scale. Scores ranged from 1 to 6, with a higher score indicating more diabetes distress.
Of the study cohort, 88.5% used a CGM for at least 1 year, and 32.4% used a CGM for 5 or more years. Mean scores were 2.1 on the regimen distress subscale, 2.7 on the 2-item Diabetes Distress Scale and 2.8 on the emotional distress subscale, indicating moderate distress in the cohort. The two-item Diabetes Distress Scale was strongly correlated with the emotional burden subscale (r = 0.88) and the regimen distress subscale (r = 0.85) of the 17-item survey.
“One aspect of our research that we were very excited about is that this short measure of diabetes distress shares a lot of overlap with the longer subscales and may be incredibly helpful to get a quick measure of diabetes distress in a variety of studies,” Chapman and Kelly said. “For many researchers, including ourselves, we often must make hard decisions about including or not including questions simply because of the amount of time it would take for participants to answer. Seeing that this two-item measure of diabetes distress was so closely related to the longer scale in our sample shows that more researchers should be able to utilize diabetes distress in their studies.”
Younger participants (r = –0.36; P < .001) were more likely to have a higher score on the two-item scale than older participants, and those with a higher HbA1c (r = 0.23; P < .001) were more likely to have more distress than participants with a lower HbA1c.
“The clinical implications of our findings highlight the importance for diabetes educators and other health care providers to monitor people with type 1 diabetes who use CGM for signs of diabetes distress,” Chapman and Kelly said. “Moderate diabetes distress can have a real and negative impact on quality of life, even in CGM users who have low HbA1c and appear to be ‘managing well’.”
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Chapman K, et al. P601. Presented at: ADCES22; Aug. 12-15, 2022; Baltimore.
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