Purpose

It has been proposed that the negative emotional state of diabetes distress (DD) may exert a detrimental effect on glycemic outcomes of individuals struggling with diabetes-related challenges. Thus far, no study has investigated this association by utilizing individualized treatment targets of patients’ glycemic control. Therefore, we sought to identify the potential role of DD in the achievement of individualized glycemic targets (AIGTs) among persons with type 2 diabetes mellitus (T2D).

Methods

This cross-sectional study included a well-characterized outpatient group of T2D adults cared for in an academic medical center. DD was evaluated with the Diabetes Distress Scale. The AIGTs was defined according to the American Diabetes Association guidelines. Logistic regression analyses were utilized to identify independent correlates of the AIGTs.

Results

A total of 123 individuals (mean [standard deviation] age: 58.0 [6.2] years, 55.3% females) were included in the final analysis. AIGTs was observed in 43.9% of the patients. Experiencing greater DD was associated with a lower likelihood of AIGTs (unadjusted odds ratio [OR]: 0.17, 95% confidence interval [CI]: 0.08–0.34, P value < 0.001), even after accounting for additional individual-level covariates (adjusted OR: 0.18, 95% CI: 0.08–0.42, P value < 0.001). Medication adherence was also a determinant of participants’ AIGTs (adjusted OR: 1.91, 95% CI: 1.13–3.23, P value = 0.015).

Conclusion

Our findings provide novel evidence that DD likely undermines glycemic status in adult outpatients with T2D, even in the context of individually tailored diabetes care, and this should be taken into account when necessary.

中文翻译：

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糖尿病困扰与成人2型糖尿病的个体化血糖控制有关

目的

已经提出，糖尿病困扰（DD）的负面情绪状态可能对患有糖尿病相关挑战的个体的血糖结果产生有害影响。迄今为止，还没有研究通过利用患者血糖控制的个体化治疗目标来研究这种关联。因此，我们试图确定DD在2型糖尿病（T2D）患者中实现个体化血糖目标（AIGT）的潜在作用。

方法

这项横断面研究包括一个在学术医学中心接受护理的特征明确的T2D成人门诊患者。DD用糖尿病困扰量表评估。AIGT是根据美国糖尿病协会指南定义的。使用逻辑回归分析来识别AIGT的独立相关性。

结果

最终分析总共包括123个人（平均[标准差]年龄：58.0 [6.2]岁，女性55.3％）。在43.9％的患者中观察到AIGT。即使考虑了额外的个体水平协变量（调整后），DD越高也意味着AIGT发生率越低（未调整优势比[OR]：0.17，95％置信区间[CI]：0.08-0.34，P值<0.001）。或：0.18，95％CI：0.08-0.42，P值<0.001）。服药依从性也是参与者AIGT的决定因素（调整后的OR：1.91，95％CI：1.13-3.23，P值= 0.015）。

结论

我们的发现提供了新颖的证据，即使在个体定制的糖尿病护理中，DD也可能破坏成年T2D门诊患者的血糖状态，因此在必要时应予以考虑。