Children's National Hospital, Center for Translational Research, USA.
Department of Pediatrics, Vanderbilt University Medical Center, USA.
J Pediatr Psychol. 2022 Sep 15;47(9):1081-1089. doi: 10.1093/jpepsy/jsac049.
Diabetes distress (DD) is a negative emotional response related to the burdens of living with type 1 diabetes (T1D) and is linked with diabetes outcomes, such as hemoglobin A1c (A1c). Yet, less is known about how other glycemic indicators, average blood glucose and time in range, relate to DD, and which demographic characteristics are associated with higher DD.
In total, 369 teens (Mage 15.6 ± 1.4, 51% female, MT1D duration 6.7 ± 3.8 years) screened for DD using The Problem Areas in Diabetes-Teen Version to determine eligibility for an ongoing multi-site behavioral trial. The associations of DD, demographic factors, and glycemic indicators (A1c, average blood glucose, and time in range) were analyzed.
Twenty-nine percent of teens (n = 95) scored above the clinical cutoff (≥44) for DD. Females scored significantly higher on average than males. Black/African American, non-Hispanic youth screened significantly higher compared to youth from other racial/ethnic groups. Higher DD scores were related to higher A1c and average blood glucose, and lower time in range. Logistic regression models revealed that females were significantly more likely to report clinically elevated DD than males, and teens with higher A1c were 1.3 times more likely to report DD. Age and diabetes duration were not significantly associated with clinically elevated DD scores.
Results demonstrated that DD is most prevalent in Black, non-Hispanic and female teens, and DD is associated with higher average blood glucose and lower time in range. Further investigation into these disparities is warranted to promote optimal health outcomes for teens with T1D.
糖尿病困扰（DD）是一种与 1 型糖尿病（T1D）患者生活负担相关的负面情绪反应，与血糖控制结果（如糖化血红蛋白（A1c））相关。然而，对于其他血糖指标（平均血糖和达标时间）与 DD 的关系，以及哪些人口统计学特征与较高的 DD 相关，了解较少。
共有 369 名青少年（平均年龄 15.6±1.4 岁，51%为女性，MT1D 病程 6.7±3.8 年）接受了青少年糖尿病问题区域量表（The Problem Areas in Diabetes-Teen Version）的 DD 筛查，以确定是否符合正在进行的多中心行为试验的入选标准。分析了 DD、人口统计学因素和血糖指标（A1c、平均血糖和达标时间）之间的关系。
29%的青少年（n=95）的 DD 评分超过临床临界值（≥44）。女性的平均得分显著高于男性。黑人和非西班牙裔青少年的筛查得分明显高于其他种族/族裔群体的青少年。DD 评分较高与 A1c 较高、平均血糖较高和达标时间较低有关。Logistic 回归模型显示，女性报告临床显著 DD 的可能性显著高于男性，A1c 较高的青少年报告 DD 的可能性是前者的 1.3 倍。年龄和糖尿病病程与临床显著 DD 评分无显著相关性。
结果表明，DD 在黑人、非西班牙裔和女性青少年中最为常见，DD 与较高的平均血糖和较低的达标时间相关。需要进一步研究这些差异，以促进 T1D 青少年的最佳健康结果。
