Clinical phenotyping of people living with type 1 diabetes according to their levels of diabetes-related distress: results from the SFDT1 cohort.

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2025-02-24 DOI:10.1136/bmjdrc-2024-004524

Dulce Canha, Gloria Aguayo, Emmanuel Cosson, Patricia Vaduva, Eric Renard, Fawaz Alzaid, Fabrice Bonnet, Samy Hadjadj, Louis Potier, Bruno Vergès, Sandrine Lablanche, Pierre Yves Benhamou, Helene Hanaire, Yves Reznik, Jean-Pierre Riveline, Guy Fagherazzi

{"title":"Clinical phenotyping of people living with type 1 diabetes according to their levels of diabetes-related distress: results from the SFDT1 cohort.","authors":"Dulce Canha, Gloria Aguayo, Emmanuel Cosson, Patricia Vaduva, Eric Renard, Fawaz Alzaid, Fabrice Bonnet, Samy Hadjadj, Louis Potier, Bruno Vergès, Sandrine Lablanche, Pierre Yves Benhamou, Helene Hanaire, Yves Reznik, Jean-Pierre Riveline, Guy Fagherazzi","doi":"10.1136/bmjdrc-2024-004524","DOIUrl":null,"url":null,"abstract":"Introduction: Type 1 diabetes is burdensome, requiring complex daily management and making people more prone to emotional distress. To better detect diabetes-related distress (DD) and identify at-risk patients, we aimed to provide an in-depth characterization of DD in people with type 1 diabetes.Research design and methods: We included adults with type 1 diabetes from the Suivi en France des personnes avec un Diabète de Type 1 cohort who filled in the Problem Areas in Diabetes questionnaire (PAID ≥40 indicates high DD). Age and sex-adjusted multivariable logistic regression models analyzed individual characteristics, clinical indicators, diabetes-related complications and psychological factors. We further analyzed DD according to six data-driven subdimensions: emotional distress, fear of complications, social distress, eating distress, management distress, and diabetes burnout.Results: In total, 1220 participants (50.6% female, age 42 years (SD 13.9), diabetes duration 24.7 years (13.6)) had a total mean PAID score of 39.6 (21.7) and 592 (48.5%) reported high DD. Leading subdimensions of DD included fear of complications (50.1 (24.4)) and diabetes burnout (45.9 (24.5)). Females, younger age, social vulnerability, smoking, and the presence of retinopathy were positively associated with high DD (p<0.05). We observed similar DD levels across HbA1c levels and treatment modalities, including automated insulin delivery and continuous glucose monitoring use. Several psychological factors, such as anxiety/depression, poor sleep quality, and treatment burden, were strongly associated with DD (p<0.001).Conclusions: We provide a holistic clinical phenotyping approach that enables the identification of determinants and prevalence of DD, overall and according to key DD subdimensions, in a large and diverse population. Our results underscore the importance of developing DD-targeted prevention and intervention strategies focused specifically on high-risk groups and the most impactful distress subdimensions to reduce the impact of type 1 diabetes burden.Trial registration number: NCT04657783.","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"13 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865782/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open Diabetes Research & Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjdrc-2024-004524","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Type 1 diabetes is burdensome, requiring complex daily management and making people more prone to emotional distress. To better detect diabetes-related distress (DD) and identify at-risk patients, we aimed to provide an in-depth characterization of DD in people with type 1 diabetes.

Research design and methods: We included adults with type 1 diabetes from the Suivi en France des personnes avec un Diabète de Type 1 cohort who filled in the Problem Areas in Diabetes questionnaire (PAID ≥40 indicates high DD). Age and sex-adjusted multivariable logistic regression models analyzed individual characteristics, clinical indicators, diabetes-related complications and psychological factors. We further analyzed DD according to six data-driven subdimensions: emotional distress, fear of complications, social distress, eating distress, management distress, and diabetes burnout.

Results: In total, 1220 participants (50.6% female, age 42 years (SD 13.9), diabetes duration 24.7 years (13.6)) had a total mean PAID score of 39.6 (21.7) and 592 (48.5%) reported high DD. Leading subdimensions of DD included fear of complications (50.1 (24.4)) and diabetes burnout (45.9 (24.5)). Females, younger age, social vulnerability, smoking, and the presence of retinopathy were positively associated with high DD (p<0.05). We observed similar DD levels across HbA1c levels and treatment modalities, including automated insulin delivery and continuous glucose monitoring use. Several psychological factors, such as anxiety/depression, poor sleep quality, and treatment burden, were strongly associated with DD (p<0.001).

Conclusions: We provide a holistic clinical phenotyping approach that enables the identification of determinants and prevalence of DD, overall and according to key DD subdimensions, in a large and diverse population. Our results underscore the importance of developing DD-targeted prevention and intervention strategies focused specifically on high-risk groups and the most impactful distress subdimensions to reduce the impact of type 1 diabetes burden.

Trial registration number: NCT04657783.

查看原文本刊更多论文

1型糖尿病患者根据糖尿病相关痛苦水平的临床表型：来自SFDT1队列的结果

1型糖尿病负担沉重，需要复杂的日常管理，使人们更容易出现情绪困扰。为了更好地检测糖尿病相关窘迫（DD）并识别高危患者，我们旨在提供1型糖尿病患者DD的深入特征。研究设计和方法：我们纳入了来自Suivi en France des persones avec un diabetes de 1型糖尿病队列的成人1型糖尿病患者，他们填写了糖尿病问题领域问卷（PAID≥40表示DD高）。调整年龄和性别的多变量logistic回归模型分析了个体特征、临床指标、糖尿病相关并发症和心理因素。我们根据六个数据驱动的子维度进一步分析DD：情绪困扰、对并发症的恐惧、社交困扰、饮食困扰、管理困扰和糖尿病倦怠。结果：共有1220名参与者（50.6%为女性，年龄42岁（SD 13.9），糖尿病病程24.7年（13.6））的总平均PAID评分为39.6(21.7),592（48.5%）报告DD高。DD的主要亚维度包括对并发症的恐惧（50.1(24.4)）和糖尿病倦怠（45.9(24.5)）。女性，年轻，社会脆弱性，吸烟和视网膜病变的存在与高DD呈正相关(结论：我们提供了一个整体的临床表型方法，可以根据DD的关键亚维度，在一个庞大和多样化的人群中确定DD的决定因素和患病率。我们的研究结果强调了制定针对高危人群和最具影响力的痛苦子维度的dd预防和干预策略的重要性，以减少1型糖尿病负担的影响。试验注册号：NCT04657783。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.