The ADA recommends psychosocial assessment as an integrated part of care for people with diabetes, which includes diabetes-related distress. Elevated diabetes-related distress is associated with poor self-management, lower medication adherence, and poorer quality of life. Intensive insulin delivery is achieved with a combination of basal and bolus dosing, which attempts to mimic normal pancreatic function. Delivery methods can be either multiple daily injections (MDI) via a syringe or pen or through continuous subcutaneous insulin injection (CSII). CSII is recommended for patients with type 1 diabetes (T1DM) who prefer pump therapy over MDI. Thus, we explored the relationship of insulin delivery method (MDI versus CSII) to diabetes-related distress in patients with T1DM.

The Diabetes Center of Excellence (DCOE), a specialty clinic for military health system beneficiaries, administered the 17-item Diabetes-related Distress Scale (DDS-17) from June 2015 through August 2016 as standard care. Adults with T1DM receiving diabetes care at the DCOE were included in this study.

There were 203 patients with T1DM who completed the DDS-17 during the time period. Patients were categorized as CSII (57.6%) or MDI (42.4%). There were no significant differences in diabetes-related distress by insulin delivery method. Furthermore, no significant differences were found in HbA1c between CSII (7.85%) and MDI (8.10%) users. In addition, no significant differences in BMI between patients using CSII (M=28.33 kg/m2) and MDI (28.49 kg/m2) users.

Our study demonstrated that there were no differences in diabetes distress scores, HbA1c, or BMI between CSII and MDI. As we move toward more patient-centered care, patients with T1DM may benefit from choosing the method of delivery that will enable them to achieve individual goals without increased diabetes-related distress.


J.L. Wardian: None. M.W. True: None. J.A. Colburn: None. I. Folaron: None. J.M. Tate: None. D. Beckman: None.

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