Diabetes rates in southeastern Ohio are more than double the national average (19.9% vs. 9.4%). Here, people battle a poverty rate 1.5 times that of the U.S. average, and suffer from higher unemployment, lower educational achievement, poorer health, and lower access to care. Despite the high presence of social determinants of health, the impact of diabetes is understudied and one critical outcome that has not been addressed is diabetes distress. We conducted a cross-sectional survey study with 121 students, faculty, and staff at a large university in Appalachian Ohio (A1C=7.3±1.4%, age=36±17years; female=60%; white=86%; type 2 diabetes=54%; duration=10±9 years, 48%=college degree or more). Diabetes distress was assessed using the Diabetes Distress Scale for type 2 diabetes and for type 1 diabetes; depressive symptoms were assessed using the Patient Health Questionnaire-9. Of the 65 type 2 diabetes participants, 34% (n=19) reported moderate to severe diabetes distress, with 48% (n=31) experiencing moderate to severe distress on the Regimen subscale. Among the 56 type 1 participants, 26% (n=15) reported moderate to severe diabetes distress, with 51% (n=28) experiencing moderate to severe distress on the Powerlessness subscale. Multiple regression analyses found high scores of diabetes distress (standardized b= 0.62, p=0.03) were independently associated with higher A1C levels after controlling for depressive symptoms (standardized b=0.01, p=79), age (standardized b= -0.03, p=0.14) and gender (standardized b=0.75, p<=.08). This model accounted for 29% of the variation in A1C. Multiple regression analyses using the same model found no association between type 2 diabetes, distress, and A1C; the lack of significance may be explained by well-educated, working adults with private insurance. Next steps include recruiting type 1 and type 2 patients from local specialty and primary care clinics to enhance representativeness. These data will help providers individualize clinical approaches for patient’s diabetes distress level.


E.A. Beverly: None. E.H. Guseman: None. K.A. Cook: None. A.M. Healy: None.

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