SAT-265 Diabetes Distress in Adolescents with Type 1 Diabetes Transitioning to Adult Care

Abstract

Introduction: Diabetes Distress refers to the negative emotional impact and unremitting frustrations associated with living with type 1 diabetes (T1D).1 While multiple scales have been developed to assess diabetes distress, the T1D Diabetes Distress Scale (T1-DDS) is a recently-validated scale designed to quantify diabetes distress in individuals with T1D specifically.2 This scale consists of 28 items assessed on a 6-point Likert-type scale, grouped into 7 subscales: powerlessness, management distress, hypoglycemia, negative social perceptions, eating distress, physician distress, and friend/family distress. Diabetes distress in adolescents with diabetes has been previously evaluated,3 but previous studies have not looked at the T1-DDS in the adolescent transition population specifically. The purpose of this study was to characterize diabetes distress in adolescents transitioning to adult care using the T1-DDS. Methods: Between 2016-2018, we recruited 100 adolescents with T1D at their last pediatric visit before transitioning to adult care. We collected demographic and basic clinical data and administered the T1-DDS using RedCap, an online data management platform. We analyzed T1-DDS scores as a continuous variable and used linear regression to determine the demographic and clinical factors associated with diabetes distress (and each diabetes distress subscale) in this population. We used the Bonferroni correction to account for multiple comparisons for each T1-DDS subscale. Results: 68% of participants completed the T1-DDS in its entirety and the mean T1-DDS score for each question was 1.93 (standard deviation 0.83), where 1 indicates low diabetes distress and where 6 indicates high diabetes distress. The only variable that was consistently associated with higher diabetes distress across most T1-DDS subscales was female sex (p <0.001 for T1-DDS total score). Higher average A1C was associated with higher diabetes distress on the management distress subscale (p = 0.009). More frequent hospitalizations were associated with higher diabetes distress in the total T1-DDS score (p = 0.009), the hypoglycemia subscale (p = 0.009), and the friend/family distress subscale (p = 0.009). Conclusions: Consistent with previous studies, female sex and poorer glycemic control were associated with higher diabetes distress.1-3 This study showed that the T1-DDS can be used to identify diabetes distress in adolescents with T1D as they transition to adult care. Future research should collect one-year post-transition T1-DDS scores in this cohort of patients.