Levels of diabetes distress and its sources among older adults with type 1 diabetes and relationships to diabetes duration.

Abstract

Objective: Characterize diabetes distress (DD) in older adults with type 1 diabetes (T1D) and explore associations with individual-level characteristics.

Research design & methods: Adults ≥65 years with T1D (n = 337; mean 70.7 years) were recruited from the T1D Exchange (08/27/2024-11/05/2024) to complete an electronic survey, including the Type 1 Diabetes Distress Assessment System. Univariable linear regressions were used to assess cross-sectional associations between DD and self-reported sociodemographic, clinical, and diabetes-related variables. Select variables were explored further using bar graphs of DD core and source scores.

Results: The median (IQR) DD core score was 1.75 (1.375-2.5), and 36.5 % of respondents had a clinically significant DD core score. DD was positively associated with being female (β = 0.37; 95 % CI: 0.20-0.55), higher HbA1c (β = 0.32; 95 % CI: 0.21-0.43), and an emergency room (ER) visit in the past year (β = 0.33; 95 % CI: 0.12-0.53). DD was negatively associated with longer T1D duration (β = -0.01; 95 % CI: -0.02 to -0.01). The most prominent sources of DD were financial, management, and complication worries, and the least prominent were interpersonal, shame, and resources.

Conclusions: In addition to known correlates of DD among individuals with T1D (e.g., HbA1c), this study revealed novel correlates of DD among older adults, including older age at diagnosis, at least one ER visit within the last 12 months, and shorter T1D duration. Limitations include self-reported variables, the cross-sectional nature, and a relatively homogeneous sample by race, high prevalence of technology use, and HbA1c levels largely at goal.