Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

2022 ◽  
Author(s):  
Paula M. Trief ◽  
Diane Uschner ◽  
Melinda Tung ◽  
Marsha D. Marcus ◽  
Maria Rayas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Anxiety Symptoms ◽  
Diabetes Distress ◽  
Emotional Burden ◽  
Factors Associated ◽  
Onset Type ◽  
Healthcare Coverage ◽  
High Distress ◽  
Logistic Regressions

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

scholarly journals Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

2022 ◽  
Author(s):  
Paula M. Trief ◽  
Diane Uschner ◽  
Melinda Tung ◽  
Marsha D. Marcus ◽  
Maria Rayas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Anxiety Symptoms ◽  
Diabetes Distress ◽  
Emotional Burden ◽  
Factors Associated ◽  
Onset Type ◽  
Healthcare Coverage ◽  
High Distress ◽  
Logistic Regressions

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

scholarly journals Diabetes Distress in Young Adults With Youth-Onset Type 2 Diabetes: TODAY2 Study Results

Diabetes Care ◽  
2022 ◽  
Author(s):  
Paula M. Trief ◽  
Diane Uschner ◽  
Melinda Tung ◽  
Marsha D. Marcus ◽  
Maria Rayas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Anxiety Symptoms ◽  
Diabetes Distress ◽  
Emotional Burden ◽  
Health Care Coverage ◽  
Factors Associated ◽  
Onset Type ◽  
High Distress

OBJECTIVE To assess the prevalence of high diabetes distress and associated factors in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY2) study cohort of young adults with youth-onset type 2 diabetes. RESEARCH DESIGN AND METHODS Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (sex, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, offspring, health care coverage, established with diabetes care provider). Univariate logistic regression identified factors associated with high distress that were controlled for in multivariate logistic regressions. RESULTS Of 438 participants, 66% were female (mean age 26.8 years, 18% non-Hispanic White, 37% non-Hispanic Black, 38% Hispanic). High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high regimen distress and 29.7% with high emotional burden. A greater percentage of those with high distress were female (P = 0.002), diagnosed with hypertension (P = 0.037) and retinopathy (P = 0.005), treated with insulin, had higher HbA1c, and had moderate to severe depressive and anxiety symptoms (all P &lt; 0.001). In multivariate analyses, female sex (P &lt; 0.001), HbA1c (P &lt; 0.001), anxiety symptoms (P = 0.036), and lack of health care coverage (P = 0.019) were associated with high distress, after controlling for potential confounders. Moderate to severe depressive symptoms were associated with high regimen distress (P = 0.018) and emotional burden (P &lt; 0.001); insulin treatment was associated with high emotional burden (P = 0.027). CONCLUSIONS Future research should identify modifiable factors associated with high diabetes distress in young adults with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.

scholarly journals Spousal Influence on Diabetes Self-care: Moderating Effects of Distress and Relationship Quality on Glycemic Control

2020 ◽  
Author(s):  
Emily C Soriano ◽  
James M Lenhard ◽  
Jeffrey S Gonzalez ◽  
Howard Tennen ◽  
Sy-Miin Chow ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Relationship Quality ◽  
Self Care ◽  
Glucose Variability ◽  
Diabetes Distress ◽  
Sample Mean ◽  
Spousal Influence ◽  
High Distress

Abstract Background Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. Purpose We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. Methods Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. Results The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. Conclusions This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.

scholarly journals Prenatal, Obstetric and Perinatal Factors Associated With the Development of Childhood-Onset Type 2 Diabetes

2018 ◽  
Vol 42 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Julie Halipchuk ◽  
Beverley Temple ◽  
Allison Dart ◽  
Donna Martin ◽  
Elizabeth A.C. Sellers
Keyword(s):  
Type 2 Diabetes ◽  
Perinatal Factors ◽  
Childhood Onset ◽  
Factors Associated ◽  
Onset Type

scholarly journals Clinical and sociodemographic variables associated with diabetes-related distress in patients with type 2 diabetes mellitus

2016 ◽  
Vol 14 (3) ◽  
pp. 346-351 ◽  
Author(s):  
Flávia Cristina Zanchetta ◽  
Danilo Donizetti Trevisan ◽  
Priscila Peruzzo Apolinario ◽  
Juliana Bastoni da Silva ◽  
Maria Helena de Melo Lima
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Marital Status ◽  
Diabetes Distress ◽  
Sociodemographic Variables ◽  
Emotional Burden ◽  
Distress Scale

ABSTRACT Objective: To evaluate the relation between diabetes-related distress and the clinical and sociodemographic characteristics of type 2 diabetes mellitus patients. Methods: A cross-sectional study based on a secondary analysis of data collected at a specialized care outpatient center in Brazil. Participants completed a questionnaire on sociodemographic and clinical characteristics and the Brazilian version of the Diabetes Distress Scale (B-DDS). Results: About 31% of the 130 eligible patients reported diabetes distress, and the mean B-DDS score was 2.6. Multiple regression analysis showed the B-DDS score was positively correlated with marital status (p=0.0230), use of diet and physical activities for diabetes management (p=0.0180), and use of insulin therapy (p=0.0030). The “emotional burden”, “regimen-related distress”, and “interpersonal distress” domains from B-DDS were associated with the use of insulin therapy (p=0.0010), marital status (p=0.0110), and the presence of three or more comorbidities (p=0.0175). Conclusion: These findings suggest the clinical and sociodemographic variables are relatively weak predictors of diabetes-related distress. The highest scores in the B-DDS were observed in the emotional burden domain, indicating the presence of diabetes distress among the participants of the study.

scholarly journals Healthcare Coverage and Glycemic Control in Young Adults with Youth-Onset Type 2 Diabetes: Results from the TODAY2 Study

2020 ◽  
Author(s):  
The TODAY Study Group ◽  
Writing Committee: ◽  
Ruth S. Weinstock ◽  
Barbara H. Braffett ◽  
Thomas J. Songer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Adults ◽  
Glycemic Control ◽  
Community Care ◽  
Treatment Options ◽  
Laboratory Data ◽  
Medicaid Expansion ◽  
Onset Type ◽  
Healthcare Coverage

<b>Objective</b>: To examine the relationship between healthcare coverage and HbA1c in young adults with youth-onset type 2 diabetes who transitioned to community diabetes care after receiving care during the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. <p><b>Research Design and Methods</b>: Participants completed questionnaires annually. HbA1c was measured in a central laboratory. Data from 2 years before and after transitioning to community care (2013-2016) were examined and compared between states with and without expanded Medicaid. </p> <p><b>Results</b>: In 2016 (n=427, mean age 24 years), two years after transitioning to community care, 93% of participants in states with Medicaid expansion had healthcare coverage compared to 68% (p<0.0001) in states without Medicaid expansion. Mean HbA1c was 9.8% in participants with government coverage, 9.3% with commercial coverage, and 10.1% in those with no coverage (p=0.0774). Additionally, 32%, 42%, and 66% of government, commercial covered, and no coverage, respectively, were not attending outpatient diabetes visits (p<0.0001). Of those with government coverage, 83% reported they had adequate coverage for insulin syringes/needles/pens, and 89% for glucose monitoring supplies, with more limited coverage in those with commercial plans. Participants with commercial coverage had higher education attainment (p<0.0001); 52% had HbA1c ≥9.0% compared to 64% of government covered and 58% with no coverage (p=0.0646).</p> <b>Conclusions</b>: More young adults with type 2 diabetes from the TODAY cohort had healthcare coverage in states with expanded Medicaid but glycemic control remained poor, regardless of coverage. New therapies and approaches are needed for this vulnerable population.

scholarly journals Psychosocial moderators of the impact of diabetes stigma: results from the second Diabetes MILES – Australia (MILES-2) study

2020 ◽  
Author(s):  
Elizabeth Holmes-Truscott ◽  
Adriana D Ventura ◽  
Sharmala Thuraisingam ◽  
Frans Pouwer ◽  
Jane Speight
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Standard Deviation ◽  
Self Efficacy ◽  
Self Esteem ◽  
Anxiety Symptoms ◽  
Diabetes Distress ◽  
Male Age

<b>Objective</b> <p>To examine the association between diabetes stigma, psychological, behavioural, and Hba1c outcomes and to investigate moderation effects of self-esteem, self-efficacy and/or social support. </p> <h3><b>Research Design and Methods</b></h3> <p>Second national Diabetes MILES–Australia (MILES-2) survey: adults with type 1 diabetes (n=959, 41% male; mean±SD age: 44±15 years), insulin-treated (n=487, 60% male; age: 61±9), and non-insulin treated type 2 diabetes (n=642, 55% male; age: 61±10). (Un)adjusted linear regression analyses tested the association between diabetes stigma (DSAS) and psychological outcomes (depressive symptoms: PHQ-8; anxiety symptoms: GAD-7; diabetes-specific distress: PAID), behavioural outcomes (healthy diet and physical activity: SDSCA), and self-reported HbA1c. Interaction effects tested whether associations varied by self-esteem (RSE), self-efficacy (CIDS) and/or diabetes-specific social support (DSS). </p> <h3><b>Results </b></h3> <p>Significant positive associations were observed between DSAS and PHQ-8, GAD-7 and PAID across diabetes type/treatment groups (all p<.001), whereby each standard deviation increase in DSAS scores was associated with an approximate half standard deviation deterioration in emotional well-being. Associations between DSAS and SDSCA and HbA1c were non-meaningful. Self-esteem moderated psychological outcomes among participants with type 1 and non-insulin treated type 2 diabetes, and diabetes distress among those with insulin-treated type 2 diabetes. Interaction effects were partially observed for social support but not for self-efficacy. </p> <h3><b>Conclusions </b></h3> <p>This study provides evidence of the association between diabetes stigma and depressive/anxiety symptoms and diabetes distress, and for the moderating effects of self-esteem and social support, among adults with type 1 and type 2 diabetes. Further research is needed to examine associations with objectively-measured behavioural and clinical outcomes. </p>

47-LB: Patient Factors Associated with Diabetes Distress among Veterans with Poorly Controlled Type 2 Diabetes

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 47-LB
Author(s):  
JASHALYNN GERMAN ◽  
ELIZABETH A. KOBE ◽  
DIANA SOLIMAN ◽  
ALLISON LEWINSKI ◽  
AMY S. JEFFREYS ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Distress ◽  
Patient Factors ◽  
Factors Associated
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