When it comes to health-related measurements that people with diabetes are asked to keep track of, blood glucose and HbA1c are probably the first that come to mind. After that, possibly blood pressure or lipid levels, and then maybe measures related to kidney function. But an important measurement that reflects the daily toll of diabetes is often neglected: diabetes distress.
For type 1 diabetes in particular, diabetes-related distress can be measured using a standardized questionnaire called the T1‐DDS diabetes distress questionnaire. This tool lets health-care providers assess the mental toll of diabetes management and diabetes-related fear and worry. Diabetes distress doesn’t always neatly correlate with diabetes control, so it’s possible that someone with excellent blood glucose numbers could also be experiencing a large amount of stress and worry.
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One reason this questionnaire isn’t more common is that many health-care providers aren’t aware of it, and among those who are, it hasn’t been always been clear how to respond to distress scores. But a recent study may point the way forward, and highlights the importance of recognizing diabetes distress.
Published in the journal Diabetic Medicine, the study looked at the effects of targeted interventions designed to reduce diabetes distress in adults with type 1 diabetes with high distress scores. It compared two groups, each containing 51 adults with type 1 diabetes with similarly elevated distress scores. Both groups completed the T1-DDS questionnaire at the beginning of the study and 9 months later, but in that period, only one group received treatment for distress.
As noted in a Healio article on the study, two interventions called OnTrack and KnowIt were used for treatment, which addressed emotional status and diabetes education. The researchers found that after 9 months, overall distress scores fell dramatically in the intervention group, along with distress related specifically to diabetes management, fear of hypoglycemia (low blood glucose), family and friend relationships, and feelings of powerlessness. The non-intervention group saw minimal change in distress scores.
The researchers concluded that “participation in diabetes distress-targeted interventions led to dramatic reductions in diabetes distress relative to similar but untreated individuals,” and that “elevated diabetes distress, when left unaddressed, does not resolve over time and often remains chronic.”
A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.