Objective: Adults with diabetes frequently experience emotional difficulties, and it is necessary to be aware of how various indicators of emotional difficulties relate to glycemic control. The objective was to investigate the connections between glycosylated hemoglobin (HbA1c), diabetes-specific emotional distress, depression, and anxiety, and overall well-being.
Methods: The Diabetes Distress Scale, the Problem Areas in Diabetes Survey, the Hospital Anxiety and Depression Scale, and the World Health Organization-Five Well-Being Index were all completed by 235 (74 percent) of the 319 adults with type 1 diabetes who were attending the endocrinology outpatient clinic at a university hospital in Norway. To determine HbA1c, blood samples were taken at the time of data collection. Diabetes-specific emotional distress, anxiety, depression, and overall well-being were all found to be associated with HbA1c in regression analyses. Nonlinearity in the relationship between HbA1c and diabetes-specific emotional distress was investigated.
Results: Glycemic control was linked to diabetes-specific emotional distress (DDS total: P .001, unstandardized coefficient = 0.038; Total PAID: depression, anxiety, and general well-being were not (coefficient = 0.021, P =.007). On the DDS, just routine related trouble was autonomously connected with HbA1c (coefficient = 0.056, P < .001). A difference of 0.6 in HbA1c is associated with a difference in baseline regimen distress of 0.5 standard deviation. The relationship between diabetes-specific distress and HbA1c was not significantly nonlinear.
Conclusions: Health care providers should distinguish between depression and diabetes-specific emotional distress in clinical consultations to encourage appropriate care strategies. Glycemic control may be improved by addressing emotional distress associated with diabetes, particularly regimen distress, during clinical consultation.
Depression; Anxiety; Diabetes-specific emotional distress; HbA1c; Type 1 diabetes
