Symptoms of Autonomic Nervous System Dysregulation and Diabetes Distress in Adults with Type 1 and Type 2 Diabetes

Objective: To test the association of autonomic nervous system (ANS) dysregulation symptoms and diabetes distress (DD) in adults with type 1 (T1D; Study 1) and type 2 diabetes (T2D: Study 2)

Research Design and Methods: 556 T1D adults and 299 T2D adults completed the Body Perception Questionnaire (BPQ) to assess ANS reactivity symptoms, diabetes distress (DDS-T1, DDS-17), anxiety (GAD-7), depression (PHQ-8) and demographic variables via internet surveys.

Results: Study 1: Mean age 45.1 years (S.D. 15.7), female (73.2%) and White (95.3%). Mean self-reported A1c was 6.7% (S.D. = 1.0%). Mean duration of T1D diagnosis 20.6 years (S.D. 14.7). 72.5% reported using an insulin pump. Mean DDS-T1 score was 2.3 (S.D. 0.8; moderate severity). BPQ mean T-scores were 48.9 (S.D. 8.4) for supradiaphragmatic and 50.6 (S.D. 8.9) for subdiaphragmatic reactivity subscales.

Study 2: Mean age 60.2 years (S.D. 13.6), female (58.7%) and White (82.9%). Mean self-reported A1c was 7.0% (S.D. 1.2%) treated by oral hypoglycemic agents (51.8%) or oral and injectable medications (39.9%). Mean duration of T2D diagnosis was 15.0 years (S.D. 10.0). Mean DDS-17 score was 2.3 (S.D. 1.0; moderate severity). BPQ mean T-scores were 49.9 (S.D. 9.4) for supradiaphragmatic and 52.0 (S.D. 8.8) for subdiaphragmatic reactivity subscales.

Controlling for covariates, severity of DDS-T1/DDS-17 significantly predicted elevations in ANS symptom T-scores on all subscales (all p ≤ 0.05), with ‘high’ DDS having the highest BPQ scores.

Conclusions: These findings demonstrate a relationship between ANS reactivity and DDS in T1D and T2D samples.