American Diabetes Association
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Diabetes distress and associations with demographic and clinical variables. A nationwide population-based registry study of 10,186 adults with type 1 diabetes in Norway

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posted on 2023-11-03, 17:36 authored by Ingvild Hernar, John G. Cooper, Roy M. Nilsen, Timothy C. Skinner, Ragnhild B. Strandberg, Marjolein M. Iversen, Marit Graue, Tony Ernes, Karianne F. Løvaas, Tone V. Madsen, Silje S. Lie, David A. Richards, Grethe Å. Ueland, Anne Haugstvedt


Estimate diabetes distress prevalence and associations with demographic and clinical variables among adults with type 1 diabetes in Norway.

Research Design and Methods

In this nationwide population-based registry study, the Problem Areas in Diabetes (PAID-20) was sent to 16,255 adults with type 1 diabetes. Linear regression models examined associations of demographic and clinical variables with distress.


In total, 10,186 people (62.7%) completed the PAID-20; mean score 25.4 (SD 18.4) and 21.7% reported high distress. Respondents endorsed worrying about the future and complications as the most problematic item (23.0%). Female sex, younger age, non-European origin, primary education only, unemployment, smoking, continuous glucose monitoring usage, more symptomatic hypoglycemia, reduced foot sensitivity, treated retinopathy and higher HbA1c were associated with higher distress.


Diabetes distress is common among adults with type 1 diabetes and associated with clinically relevant factors, underlining that regular care should include efforts to identify and address distress


The Western Norway University of Applied Sciences, the Norwegian Nursing Association, and the Western Norway Regional Health Authority funded the study.