700-P: Recent and Lifetime Experiences with Diabetes Distress in Adults with Type 1 Diabetes

Introduction & Objective: Measures of diabetes distress (DD) identify when individuals with T1D are struggling but are often limited to experiences within the past month. Lived experiences of DD may be more variable, as T1D is a lifetime illness. Thus, we examined qualitative experiences with recent versus lifetime DD, then compared two groups (with/without recent DD) on established measures of DD.

Methods: Adults from the T1D Exchange Registry (N = 272) completed an online survey and were asked (yes/no) if they had experienced recent DD (i.e., in the past 12 months). Then, participants described their DD experiences (‘yes’ = past 12 months experiences; ‘no’ = lifetime experiences). Thematic analysis was used to categorize responses. Participants also completed the DDS-2, and two T1DDS subscales: Powerlessness and Physician Distress. Welch's t-tests compared means between groups (DDyes vs. DDno).

Results: Most participants reported DD in the past 12 months (n DDyes = 241 vs. n DDno = 31). Both DDyes (32.0%) and DDno (34.4%) groups described DD around T1D management. The DDyes group described challenges in daily life with T1D (11.7%) and financial burden (11.3%). The DDno group described distress in adolescence (18.8%) and no experiences with DD (25.8%). Compared to the DDno group, the DDyes group was younger (t(37.7) = -2.9, p < 0.01), had T1D for fewer years (t(39.2)= -2.9, p < 0.01), and higher scores on all measures of DD: DDS-2 (t(58.3)= 10.1, p < 0.01), Powerlessness (t(52.2)= 9.3, p < 0.01), and Physician Distress (t(65.3)= 4.9, p<0.01). Yet, depending on measure, not all participants in the DDyes group met cutoff scores for ‘moderate-to-high’ DD: Physician Distress = 35.3%, DDS-2 = 49.8%, Powerlessness = 81.3%.

Conclusion: Most participants reported DD experiences within the past year. However, validated measures did not always classify those who reported recent experiences with higher DD. Thus, providers should consider using DD measures in conjunction with discussions of lived experiences in adults with T1D.