TY - JOUR
T1 - Clinical phenotyping of people living with type 1 diabetes according to their levels of diabetes-related distress
T2 - Results from the SFDT1 cohort
AU - Canha, Dulce
AU - Aguayo, Gloria
AU - Cosson, Emmanuel
AU - Vaduva, Patricia
AU - Renard, Eric
AU - Alzaid, Fawaz
AU - Bonnet, Fabrice
AU - Hadjadj, Samy
AU - Potier, Louis
AU - Vergès, Bruno
AU - Lablanche, Sandrine
AU - Benhamou, Pierre Yves
AU - Hanaire, Helene
AU - Reznik, Yves
AU - Riveline, Jean Pierre
AU - Fagherazzi, Guy
N1 - Funding:
DC is supported by the Luxembourg National Research Fund (grant number PRIDE21/16749720). This work was made possible thanks to the institutional support from the Fondation Francophone pour la Recherche sur le Diabète (FFRD), the Société Francophone du Diabète (SFD) and the Luxembourg
Institute of Health, as well as from the following partners: Breakthrough T1D/JDRF, Aide aux Jeunes Diabétiques (AJD), Fédération Française des Diabétiques, Lilly, Abbott, Air Liquide Healthcare, Novo Nordisk, Sanofi, Insulet, Medtronic, Dexcom, Ypsomed, LifeScan and Sur les Pas de So
Publisher Copyright:
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
PY - 2025/2/24
Y1 - 2025/2/24
N2 - Introduction Type 1 diabetes is burdensome, requiring complex daily management and making people more prone to emotional distress. To better detect diabetes-related distress (DD) and identify at-risk patients, we aimed to provide an in-depth characterization of DD in people with type 1 diabetes. Research design and methods We included adults with type 1 diabetes from the Suivi en France des personnes avec un Diabète de Type 1 cohort who filled in the Problem Areas in Diabetes questionnaire (PAID ≥40 indicates high DD). Age and sex-adjusted multivariable logistic regression models analyzed individual characteristics, clinical indicators, diabetes-related complications and psychological factors. We further analyzed DD according to six data-driven subdimensions: emotional distress, fear of complications, social distress, eating distress, management distress, and diabetes burnout. Results In total, 1220 participants (50.6% female, age 42 years (SD 13.9), diabetes duration 24.7 years (13.6)) had a total mean PAID score of 39.6 (21.7) and 592 (48.5%) reported high DD. Leading subdimensions of DD included fear of complications (50.1 (24.4)) and diabetes burnout (45.9 (24.5)). Females, younger age, social vulnerability, smoking, and the presence of retinopathy were positively associated with high DD (p<0.05). We observed similar DD levels across HbA1c levels and treatment modalities, including automated insulin delivery and continuous glucose monitoring use. Several psychological factors, such as anxiety/depression, poor sleep quality, and treatment burden, were strongly associated with DD (p<0.001). Conclusions We provide a holistic clinical phenotyping approach that enables the identification of determinants and prevalence of DD, overall and according to key DD subdimensions, in a large and diverse population. Our results underscore the importance of developing DD-targeted prevention and intervention strategies focused specifically on high-risk groups and the most impactful distress subdimensions to reduce the impact of type 1 diabetes burden. Trial registration number NCT04657783.
AB - Introduction Type 1 diabetes is burdensome, requiring complex daily management and making people more prone to emotional distress. To better detect diabetes-related distress (DD) and identify at-risk patients, we aimed to provide an in-depth characterization of DD in people with type 1 diabetes. Research design and methods We included adults with type 1 diabetes from the Suivi en France des personnes avec un Diabète de Type 1 cohort who filled in the Problem Areas in Diabetes questionnaire (PAID ≥40 indicates high DD). Age and sex-adjusted multivariable logistic regression models analyzed individual characteristics, clinical indicators, diabetes-related complications and psychological factors. We further analyzed DD according to six data-driven subdimensions: emotional distress, fear of complications, social distress, eating distress, management distress, and diabetes burnout. Results In total, 1220 participants (50.6% female, age 42 years (SD 13.9), diabetes duration 24.7 years (13.6)) had a total mean PAID score of 39.6 (21.7) and 592 (48.5%) reported high DD. Leading subdimensions of DD included fear of complications (50.1 (24.4)) and diabetes burnout (45.9 (24.5)). Females, younger age, social vulnerability, smoking, and the presence of retinopathy were positively associated with high DD (p<0.05). We observed similar DD levels across HbA1c levels and treatment modalities, including automated insulin delivery and continuous glucose monitoring use. Several psychological factors, such as anxiety/depression, poor sleep quality, and treatment burden, were strongly associated with DD (p<0.001). Conclusions We provide a holistic clinical phenotyping approach that enables the identification of determinants and prevalence of DD, overall and according to key DD subdimensions, in a large and diverse population. Our results underscore the importance of developing DD-targeted prevention and intervention strategies focused specifically on high-risk groups and the most impactful distress subdimensions to reduce the impact of type 1 diabetes burden. Trial registration number NCT04657783.
KW - Adult
KW - Diabetes Mellitus, Type 1
KW - Phenotype
KW - Psychology
UR - http://www.scopus.com/inward/record.url?scp=85219044088&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/40000027/
U2 - 10.1136/bmjdrc-2024-004524
DO - 10.1136/bmjdrc-2024-004524
M3 - Article
C2 - 40000027
AN - SCOPUS:85219044088
SN - 2052-4897
VL - 13
JO - BMJ Open Diabetes Research and Care
JF - BMJ Open Diabetes Research and Care
IS - 1
M1 - e004524
ER -