540-P: Predictors of Daily Diabetes Distress in Type 1 Diabetes

Abstract

Aim of this analysis was to analyse daily factors that lead to diabetes distress using data from an ecological momentary assessment study in combination with CGM. In the DIA-LINK study, 203 people with type 1 diabetes were asked four times a day over 17 days (EMA) while using unblinded CGM. They rated their sleep quality and the anticipated stress in the morning and their current mood, energy, and stress level four times a day. Daily diabetes distress was assessed in the evening using five adapted items from the Problem Areas in Diabetes (PAID) scale (feeling overwhelmed, alone, guilty, deprivation, diabetes takes up too much mental/physical energy). Glucose data from the 12-hour period prior to each distress rating were extracted. Using multilevel regression analysis, the sum score of daily distress was entered as dependent variable (person as nested factor). The following independent variables were used: sleep quality, anticipated stress level, mean level and coefficient of variation (CV) of mood, energy, and stress, CV of glucose, time in range, and % < 70 mg/dl; controlled for study day and age, sex, diabetes duration, HbA1c, diabetes distress, depressive symptoms (all assessed at baseline). Higher time in range and lower glucose fluctuations were predictive of lower diabetes distress, as was daily stress and energy (Table 1). Daily mood and elevated depressive symptoms had no effect. These results may help to explain the sources of diabetes distress.View largeDownload slideView largeDownload slide DisclosureD. Ehrmann: Speaker’s Bureau; Self; Berlin-Chemie AG. A. J. Schmitt: None. L. Priesterroth: None. B. Kulzer: Advisory Panel; Self; Berlin-Chemie AG, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH, Research Support; Self; Berlin-Chemie AG, Novo Nordisk, Speaker’s Bureau; Self; Berlin-Chemie AG, Dexcom, Inc., Novo Nordisk. N. Hermanns: Advisory Panel; Self; Abbott, Research Support; Self; Berlin-Chemie AG, Roche Diabetes Care, Sanofi-Aventis Deutschland GmbH.FundingGerman Center for Diabetes Research (DZD) (82DZD01102)