1166: Characterization of diabetes distress in pregnancy: A pilot study

Abstract

Patient engagement in diabetes self-care is essential for glucose control and negatively impacted by high levels of diabetes distress. This study aims to characterize diabetes distress in pregnancy. A pilot prospective, observational study was performed including pregnant women with diabetes (pregestational and gestational) or with diabetic risk factors such as obesity, excessive gestational weight gain, and pre-diabetes. The Diabetes Distress Scale (DDS), which captures specific domains of emotional, regimen-related, interpersonal and physician-related diabetes distress (DD), was administered before and after counseling with a Certified Diabetes Educator. The Edinburgh Postpartum Depression Scale (EPDS) was concomitantly administered. EPDS scores were considered clinically significant at ≥10. Accepted thresholds for clinically significant DD are scores ≥2 (moderate) and ≥3 (severe). Women were dichotomized into mild (< 2) and severe (≥2) due to the infrequency of moderate scores. Maternal demographics and clinical data were compared between mild and severe groups. Differences in scores were compared pre and post consultation. During a 4 month period, 31 women at an academic medical center between 6 and 36 weeks gestation completed pre and post surveys. Severe DD was identified in 18/31 women (58%). Eleven (38%) had overall scores in the severe range, while 7 (35%) with overall mild scores had severe distress in one or more specific domains. Only 7 women (35%) had entirely normal scores. Demographics and clinical characteristics were similar among women with mild and severe DD (Table 1). Severe DD related to the emotional burden of diabetes and regimen-related concerns predominated. After diabetes education, only 7 women had severe DD. (Table 2) In our study 58% of pregnant women suffered from clinically significant diabetes distress. Pregnant women may be vulnerable to high levels of diabetes specific distress regardless of demographic or clinical differences.View Large Image Figure ViewerDownload Hi-res image Download (PPT)