Background: Screening for future risk of diabetic kidney disease (DKD) in people with type 2 diabetes (T2D) and normal kidney function was conducted in the clinical multicenter intervention trial PRIORITY (Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe 2 diabetic patients with normoalbuminuria). Risk screening was based on a urinary proteomic analysis categorizing the patients at high or low risk for DKD. Little is known about how risk-assessments affect patients. However, screening for DKD is likely to increase diabetes distress (DD), as DD is linked to specific diabetes stressors such as worrying about complications.
Aim: To investigate to what extent DD was affected by screening and individualized information about future risk of DKD.
Methods: Of 436 participants in the Danish part of PRIORITY, 217 were asked to complete a full diabetes distress scale (DDS) and 139 completed DDS at screening visit (T1) and after provision of screening results (T2, 6 weeks after T1). DDS was repeated in 84 at a follow-up visit (T3, 12 months after T2). DD differences were explored with wilcoxon signed-rank test and subgroup differences with paired t-test.
Results: Participants’ mean age was 61 years, 37 % women, mean diabetes duration 10 years, mean HbA1c 54mmol/mol, 4 % had high overall DD and 12 % were categorized as having high risk of DKD. No significant changes were found in DD between T1, T2 and T3. Mean DD differences [SD] between T1 to T2 was 0.02 [0.38], p=0.65 and between T2 and T3 0.01 [0.35], p=0.88. No significant differences in DD changes were found when comparing participants with high vs. low initial DD or when comparing participants in high vs. low risk of DKD. However, few participants had high DD at T1 and few had high risk of DKD.
Conclusions: The study indicated that screening for future risk of DKD does not increase DD in people with T2D. Future studies should explore potential subgroup differences further as well as the mechanisms behind the results.
L.E. Joensen: None. K.P. Madsen: None. M. Frimodt-Moller: None. N. Tofte: None. I. Willaing: None. M. Lindhardt: None. P. Rossing: Advisory Panel; Self; Novo Nordisk A/S, AstraZeneca, Boehringer Ingelheim GmbH. Research Support; Self; AstraZeneca, Novo Nordisk A/S. Advisory Panel; Self; Astellas Pharma US, Inc.. Stock/Shareholder; Self; Novo Nordisk A/S. Advisory Panel; Self; Bayer AG.