In the Journals

Treating diabetes distress yields ‘dramatic’ improvements

Adults with type 1 diabetes who took part in programs designed for improving emotional reactions and education related to the disease reported less diabetes distress than those who did not participate in such programs, according to findings published in Diabetic Medicine.

“Diabetes distress refers to the often hidden emotional burdens, stresses and worries that result from managing a demanding chronic disease like type 1 diabetes over time,” Danielle Hessler, PhD, associate professor of family community medicine in the School of Medicine at the University of California, San Francisco, and colleagues wrote. “Notably, few systematic interventions have aimed directly at reducing diabetes distress among adults with type 1 diabetes.”

Hessler and colleagues examined data from 51 participants from the T1-Reducing Distress and Enhancing Effective Management study who were aged at least 21 years, had type 1 diabetes and had a mean diabetes distress score of at least 2. Individuals from this group participated in either OnTrack or KnowIt interventions, which were designed to address emotional status and education related to diabetes.

The researchers then looked at data from 51 participants matched for age, diabetes status and distress score who did not take part in these programs.

All study participants completed questionnaires about diabetes distress and had HbA1c measured at baseline and at 9 months between 2013 and 2017.

Individuals who took part in one of the programs had an average baseline diabetes distress score of 2.6, which fell to 2 at 9 months (P < .001). These participants also experienced decreases in diabetes distress related to powerlessness (3.7 vs. 2.6; P < .001), diabetes management (3 vs. 2.2; P < .001), hypoglycemia distress (2.4 vs. 1.8; P = .02) and family/friend distress (1.8 vs. 1.5; P = .008). Those who did not take part in the programs had “minimal change” in diabetes distress, according to the researchers.

Doctor female patient general 2019 
Adults with type 1 diabetes who took part in programs designed for improving emotional reactions and education related to the disease reported less diabetes distress than those who did not participate in such programs.
Source: Adobe Stock

“Results indicated that participation in diabetes distress-targeted interventions led to dramatic reductions in diabetes distress relative to similar but untreated individuals,” the researchers wrote. “These findings provide a better understanding of the clinical benefits of targeted diabetes distress interventions.”

Although there were no differences in terms of HbA1c between the two groups, 23.5% of those participating in the programs had diabetes distress that “increased significantly or persisted at high levels” while 51% of those who did not participate in the programs had such levels of distress.

“These findings suggest that high diabetes distress can become chronic if left untreated,” the researchers wrote. “Furthermore, while the targeted interventions led to significant reductions in diabetes distress, further work is needed to understand and tailor interventions to the nearly one-quarter of intervention participants who did not experience reductions in diabetes distress.” – by Phil Neuffer

Disclosures: Hessler reports she has served as a consultant and on the advisory board for Eli Lilly. Please see the study for all other authors’ relevant financial disclosures.

Adults with type 1 diabetes who took part in programs designed for improving emotional reactions and education related to the disease reported less diabetes distress than those who did not participate in such programs, according to findings published in Diabetic Medicine.

“Diabetes distress refers to the often hidden emotional burdens, stresses and worries that result from managing a demanding chronic disease like type 1 diabetes over time,” Danielle Hessler, PhD, associate professor of family community medicine in the School of Medicine at the University of California, San Francisco, and colleagues wrote. “Notably, few systematic interventions have aimed directly at reducing diabetes distress among adults with type 1 diabetes.”

Hessler and colleagues examined data from 51 participants from the T1-Reducing Distress and Enhancing Effective Management study who were aged at least 21 years, had type 1 diabetes and had a mean diabetes distress score of at least 2. Individuals from this group participated in either OnTrack or KnowIt interventions, which were designed to address emotional status and education related to diabetes.

The researchers then looked at data from 51 participants matched for age, diabetes status and distress score who did not take part in these programs.

All study participants completed questionnaires about diabetes distress and had HbA1c measured at baseline and at 9 months between 2013 and 2017.

Individuals who took part in one of the programs had an average baseline diabetes distress score of 2.6, which fell to 2 at 9 months (P < .001). These participants also experienced decreases in diabetes distress related to powerlessness (3.7 vs. 2.6; P < .001), diabetes management (3 vs. 2.2; P < .001), hypoglycemia distress (2.4 vs. 1.8; P = .02) and family/friend distress (1.8 vs. 1.5; P = .008). Those who did not take part in the programs had “minimal change” in diabetes distress, according to the researchers.

Doctor female patient general 2019 
Adults with type 1 diabetes who took part in programs designed for improving emotional reactions and education related to the disease reported less diabetes distress than those who did not participate in such programs.
Source: Adobe Stock

“Results indicated that participation in diabetes distress-targeted interventions led to dramatic reductions in diabetes distress relative to similar but untreated individuals,” the researchers wrote. “These findings provide a better understanding of the clinical benefits of targeted diabetes distress interventions.”

Although there were no differences in terms of HbA1c between the two groups, 23.5% of those participating in the programs had diabetes distress that “increased significantly or persisted at high levels” while 51% of those who did not participate in the programs had such levels of distress.

“These findings suggest that high diabetes distress can become chronic if left untreated,” the researchers wrote. “Furthermore, while the targeted interventions led to significant reductions in diabetes distress, further work is needed to understand and tailor interventions to the nearly one-quarter of intervention participants who did not experience reductions in diabetes distress.” – by Phil Neuffer

Disclosures: Hessler reports she has served as a consultant and on the advisory board for Eli Lilly. Please see the study for all other authors’ relevant financial disclosures.