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. 2024 Dec 26:19322968241308269.
doi: 10.1177/19322968241308269. Online ahead of print.

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

William H Polonsky  1   2 , Emily C Soriano  3 , Lisa A Strycker  4 , Lawrence Fisher  5
Affiliations

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

William H Polonsky et al. J Diabetes Sci Technol. .

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.

Keywords: quality of life; technology; type 1 diabetes; type 2 diabetes.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Behavioral Diabetes Institute licenses the DCS to pharmaceutical companies and other for-profit organizations; otherwise, the DCS is available free of charge for use in clinical care and research.

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References

    1. Rubin RR, Peyrot M. Quality of life and diabetes. Diabetes Metab Res Rev. 1999;15:205-218. - PubMed
    1. Speight J, Holmes-Truscott E, Hendrieckx C, Skovlund S, Cooke D. Assessing the impact of diabetes on quality of life: what have the past 25 years taught us? Diabet Med. 2020;37(3):483-492. - PubMed
    1. Alvarado-Martel D, Velasco R, Sánchez-Hernández RM, Carrillo A, Nóvoa FJ, Wägner AM. Quality of life and type 1 diabetes: a study assessing patients’ perceptions and self-management needs. Patient Prefer Adherence. 2015;9:1315-1323. - PMC - PubMed
    1. Uzoigwe C, Radin M, Hamersky CM, et al.. Quality of life in patients with type 2 diabetes after switching to insulin degludec: results from a cross-sectional survey. Qual Life Res. 2021;30(6):1629-1640. - PMC - PubMed
    1. Weatherall J, Polonsky WH, Lanar S, et al.. When insulin degludec enhances quality of life in patients with type 2 diabetes: a qualitative investigation. Health Qual Life Outcomes. 2018;16(1):87. doi:10.1186/s12955-018-0883-1. - DOI - PMC - PubMed

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