The relationships between variables of glycated hemoglobin and diabetes distress in patients with type 1 and type 2 diabetes mellitus

Abstract

Background. Diabetes distress is among potential barriers for people with diabetes mellitus (DM) to reach glycemic goals. Accumulating evidence suggests diabetes distress may be linked to individuals’ emotion regulation capacities. The purpose of this study was to explicate the relationships between variables of glyca­ted hemoglobin (HbA1c), diabetes distress, emotion regulation, and self-care variables through the analysis of cross-sectional data from individuals with type 1 and type 2 DM. Materials and methods. We used structural equation modeling to assess the cross-sectional relationships between variables of HbA1c, diabetes distress, emotion regulation, and self-care variables through the analysis of cross-sectional data from 132 individuals with type 1 and type 2 DM. After giving informed consent for their data to be used for research purposes without identifying them, study participants were examined by clinical psychologists with a structured clinical assessment and a series of other assessments relevant to DM. Results. While participants with type 2 DM differed from those with type 1 DM in terms of age, duration of DM, insulin dependence, and self-care, no significant diffe­rences were observed between the groups in sex, HbA1c levels, diabetes distress, emotion regulation-experience, or emotion regulation-skill scores. Study examined two potential explanatory models with one of them showing a more comprehensive view of the data revealing a total effect of poor emotional regulation on HbA1c levels. Diabetes distress in adults is linked to increased negative emotionality (emotion regulation-experience) and reduced skill at emotional regulation (emotion regulation-skill), both of which are associated with elevated HbA1c levels, and these relationships are stronger than those in diabetes self-care. Conclusions. This study suggests that in people with DM, elevated HbA1c levels and diabetes distress are linked to poor emotion regulation. These data emphasize that targeting difficulties in emotion regulation may hold promise for maximizing improvement in diabetes distress and HbA1c in individuals with DM.