The association of environmental mastery and diabetes distress among young adults with type 1 diabetes.

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2025-05-09 DOI:10.1111/dme.70061

Kathryn E Nagel, Tracy Dearth-Wesley, Allison N Herman, Robert C Whitaker

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引用次数: 0

Abstract

Aims: We determined whether a global measure of environmental mastery (EM) was associated with diabetes distress (DD) among young adults with type 1 diabetes (T1D).

Methods: In 2017, an online survey was completed by 423 of 743 (57%) young adults (19-31 years) with T1D receiving care at a speciality clinic in New York City. Linear regression was used to examine the association between EM scores (7-item scale from Ryff's Scales of Psychological Well-Being) and DD scores (17-item Diabetes Distress Scale), adjusting for HbA1_c levels and sociodemographic and clinical covariates.

Results: Among the 416 participants with complete data on EM and DD, the mean (SD) age was 24.5 (3.2) years. Fifty-nine per cent were female and 70% were Non-Hispanic White. The mean HbA1_c level was 64 (18) mmol/mol/8.0 (1.7) %, the mean EM score was 33.5 ± 8.7 and the mean DD score was 2.3 ± 1.0. For each 1 SD increase in EM score, there was a 0.51 SD decrease (95% confidence interval [CI]: 0.43, 0.59) in the covariate-adjusted DD score. This inverse association between EM and DD was of similar magnitude among those with HbA1_c levels in the target range (<53 mmol/mol [<7.0%]) and those with HbA1_c levels not in the target range.

Conclusions: Greater EM was associated with lower DD. Reducing DD in young adults with T1D may require a better understanding of the developmental processes that lead to a sense of global mastery.

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1型糖尿病青年患者环境控制与糖尿病困扰的关系

目的：我们确定了在1型糖尿病（T1D）的年轻成人中，环境控制（EM）的全球测量是否与糖尿病窘迫（DD）相关。方法：2017年，在纽约市一家专科诊所接受治疗的743名T1D年轻人（19-31岁）中，有423人（57%）完成了一项在线调查。采用线性回归检验EM评分（赖夫心理健康量表的7项量表）和DD评分（17项糖尿病困扰量表）之间的相关性，调整了HbA1c水平、社会人口统计学和临床协变量。结果：在416名具有完整EM和DD数据的参与者中，平均（SD）年龄为24.5（3.2）岁。其中59%为女性，70%为非西班牙裔白人。平均HbA1c水平为64 (18)mmol/mol/8.0(1.7) %，平均EM评分为33.5±8.7，平均DD评分为2.3±1.0。EM评分每增加1个标准差，经协变量调整的DD评分就会减少0.51个标准差（95%可信区间[CI]: 0.43, 0.59）。在HbA1c水平在目标范围内（c水平不在目标范围内）的患者中，EM和DD之间的负相关程度相似。结论：较高的EM与较低的DD相关。减少年轻T1D患者的DD可能需要更好地了解导致全局掌控感的发育过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”