Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May-Jun;29(4):572-7.
doi: 10.1016/j.jdiacomp.2015.01.012. Epub 2015 Feb 7.

Understanding the sources of diabetes distress in adults with type 1 diabetes

Lawrence Fisher  1 , William H Polonsky  2 , Danielle M Hessler  3 , Umesh Masharani  4 , Ian Blumer  5 , Anne L Peters  6 , Lisa A Strycker  7 , Vicky Bowyer  3
Affiliations

Understanding the sources of diabetes distress in adults with type 1 diabetes

Lawrence Fisher et al. J Diabetes Complications. 2015 May-Jun.

Abstract

Aims: To identify the unique sources of diabetes distress (DD) for adults with type 1 diabetes (T1D).

Methods: Sources of DD were developed from qualitative interviews with 25 T1D adults and 10 diabetes health care providers. Survey items were then developed and analyzed using both exploratory (EFA) and confirmatory CFA) analyses on two patient samples. Construct validity was assessed by correlations with depressive symptoms (PHQ8), complications, HbA1C, BMI, and hypoglycemia worry scale (HWS). Scale cut-points were created using multiple regression.

Results: An EFA with 305 U.S. participants yielded 7 coherent, reliable sources of distress that were replicated by a CFA with 109 Canadian participants: Powerlessness, Negative Social Perceptions, Physician Distress, Friend/Family Distress, Hypoglycemia Distress, Management Distress, Eating Distress. Prevalence of DD was high with 41.6% reporting at least moderate DD. Higher DD was reported for women, those with complications, poor glycemic control, younger age, without a partner, and non-White patients.

Conclusions: We identified a profile of seven major sources of DD among T1D using a newly developed assessment instrument. The prevalence of DD is high and is related to glycemic control and several patient demographic and disease-related patient characteristics, arguing for a need to address DD in clinical care.

Keywords: Assessing distress; Diabetes distress; Distress profile; Type 1 diabetes; Types of distress.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest:

Lawrence Fisher: Consultant to Roche Diagnostics, Elli Lilly.

Ian Blumer: Consultant to or advisory board with to Animas, Bayer, BD Diabetes, BMS/AZ, Elli Lilly, Janssen, Medtronic, Merck, Novo Nordisk, Roche, Sanofi.

William Polonsky: Consultant or advisory board with Sanofi, Novo Nordisk, Elli Lilly, Dexcom, Abbott, J&J, Boehringer Ingelheim, Takeda, Roche.

Anne Peters: Consultant or advisory board with Amgen, Abbott Diabetes Care, Becton Dickinson, Biodel, Bristol Myers Squibb/Astra-Zeneca, Janssen, Lexicon, Lilly, Medtronic Minimed, Novo Nordisk, OptumRx, sanofi, Takeda, Thermalin. Speakers bureau = Bristol Myers Squibb/Astra-Zeneca, Novo Nordisk, Janssen.

References

    1. Balfe M, Doyle F, SMight D, Screenan S, Brugha R, Hevey D, Conroy R. What's distressing about having type 1 diabetes? A qualitative study of young adults' perspectives. BMC Endocrine Disorders. 2013;13:13–25. - PMC - PubMed
    1. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–332.
    1. Delahanty LM, Grant RW, Wittenberg E, Bosch JL, Wexler DJ, Cagliero E, Meigs JB. Association of diabetes-related emotional distress with diabetes treatment in primary care patients with type 2 diabetes. Diabetic Medicine. 2007;24:48–54. - PubMed
    1. Dunn SM, Smartt H, Beeney L, Turtle J. Measurement of emotional adjustment in diabetic patients: validity and reliability of the ATT39. Diabetes Care. 1986;9:480–489. - PubMed
    1. Fisher L, Glasgow RE, Stryker LA. The relationship between diabetes distress and clinical depression among patients with type 2 diabetes. Diabetes Care. 2010;33:1034–1036. - PMC - PubMed

Publication types

MeSH terms