Impact of visit-to-visit glycated hemoglobin variability on diabetes distress and its subscales.

AIMS

This study aimed to investigate the correlations between glycated hemoglobin (HbA1C) variability and diabetes distress (DD) and its subscales in older patients with type 2 diabetes mellitus.

METHODS

The cross-sectional study analyzed 175 patients with type 2 diabetes mellitus, aged ≥60 years, and underwent HbA1C testing at least three times within a 2-year. HbA1C variability was assessed using the coefficient of variation (CV), standard deviation (SD), variability independent of the mean (VIM), and variability score. DD was assessed using a diabetes distress scale (DDS) questionnaire. We analyzed four DDS subscales, including emotional burden (EB), regimen distress (RD), interpersonal distress (ID), and physician distress (PD). Significant DD was defined as a total score ≥ 34.

RESULTS

All four indices of HbA1C variability were positively correlated with DDS (r = 0.19, P = 0.01 in CV; r = 0.19, P = 0.01 in SD; r = 0.19, P = 0.02 in VIM; and r = 0.18, P = 0.02 in variability score). For the DD subscales, only EB showed a significant correlation with HbA1C variability (β = 0.72, SE = 0.35 in CV; β = 0.70, SE = 0.35 in SD; β = 0.66, SE = 0.31 in VIM; and β = 0.77, SE = 0.35 in variability score).

CONCLUSIONS

HbA1C variability was independently linked to DD, particularly the EB subscale in older type 2 diabetes patients. This underscores the need for DD screening and intervention in patients with high HbA1C variability, irrespective of their HbA1C levels or depressive symptoms.