55-OR: Diabetes Distress among Persons Living with Latent Autoimmune Diabetes of Adults in the Canadian Cohort BETTER—A Cross-Sectional Study

Introduction: Latent autoimmune diabetes of adults (LADA) is known for a slowly progressive autoimmune destruction of beta-cells compared to type 1 diabetes while sharing clinical features with type 2 diabetes. Diabetes distress has not been assessed specifically in persons living with LADA (PwLADA) to address potential gaps in their care.

Objective: Assess diabetes distress experienced by PwLADA and compare it to persons living with type 1 diabetes (PwT1D).

Methods: Cross-sectional analysis of Diabetes Distress Scale DDS-17 filled online in the Canadian BETTER registry; Data was analyzed for 2877 participants; 266 (9%) LADA and 2611 (91%) T1D. A total distress score was calculated then items were organized and scored under four categories: emotional burden, physician distress, regimen distress and interpersonal distress. Scores were classified as low, moderate or high distress, mean item score ≥ 3 as “high distress”; chi-square was used for comparison with T1D.

Results: PwLADA vs PwT1D were 50 ± 13 y.o. vs 40 ± 16 y.o (p<0.001); 67% vs. 64% females (p 0.4); diabetes duration 10 ± 9 vs. 22 ± 15 years (p<0.001). Over half PwLADA experienced high (21%) or moderate (35%) distress according to the total distress score. Peak scores (high & moderate) were detected for emotional burden (51% & 31%); followed by interpersonal distress (19% & 27%), regimen distress (20% & 26%) and physician distress (17% &13%). Scores for all categories were comparable to those reported by PwT1D. We explored factors that could modulate distress level among PwLADA including hypoglycemia, use of technology and HbA1c. Significant differences were detected for higher regimen distress among those with severe hypoglycemia in past year (56% vs 18%, p=0.02) and those with A1c >75 mmol/mol (53% vs 11%, p<0.001).

Conclusion: Diabetes distress is highly prevalent among PwLADA, especially the emotional burden similar to PwT1D. Further research is warranted to design adequate interventions.