We studied a cohort of 3,3Japanese patients with type 2 diabetes to determine the prospective association between diabetes distress measured by problem areas in diabetes (PAID) survey at baseline and subsequent risk of all-cause mortality. Longitudinal data were obtained from this cohort who completed the PAID survey at baseline. We excluded patients with a past history of any cancer. We categorized PAID total score into quintiles and assessed the independent correlation with all-cause mortality using the Cox proportional hazards model adjusted for potential confounders [age, gender, BMI, HbA1c, diabetes therapy, urine albumin/creatinine ratio, retinopathy, diabetic neuropathy, and past medical history]. Mean patient age, BMI, and HbA1c level were 64.9 years, 24.6 kg/m2, and 7.5% (57.6 mmol/mol), respectively. Median total PAID score was 29 overall, and 21, 25, 30, 39, and 55 for the1st to 5th quintiles, respectively. We observed 251 of any death cases during median follow-up of 6.1 years. Compared with the 1st quintile of PAID score, the multi-variable adjusted hazard ratios of all-cause mortality were 1.11 (95% CI, 0.78-1.60; p = 0.56), 0.87 (95% CI, 0.56-1.35; p = 0.524), 0.95 (95% CI, 0.62-1.44; p = 0.802), and 1.60 (95% CI, 1.09-2.35; p = 0.016).

In conclusion, diabetes distress measured by the PAID survey was associated with a subsequent risk of all-cause mortality in patients with type 2 diabetes.


Y. Hayashino: None. S. Okamura: None. S. Tsujii: None. H. Ishii: None.

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