Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results
Methods: Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.
Results: Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).
Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.