588-P: Examining Psychosocial and Comorbidity Factors Associated with Diabetes Distress among Medicaid Beneficiaries

Evidence supports diabetes distress’ (distress hereafter) effect on diabetes self-management. Few studies have examined factors that influence distress. We used self-reported cross-sectional data from Medicaid beneficiaries in Louisiana to examine psychosocial and clinical factors and their associations with distress. The sample (n=345) was mostly female (75%) , age >45 (77%) , Black (65%) , >years since diabetes diagnosis (51%) , had A1c values ≥7.0% (46%) or unknown (30%) , high distress (71%) , ≥1 social needs (94%) , poor self-rated health (68%) , lower stress (54%) and depression (51%) , more social support (56%) , high # of comorbidities (7.3 ± 2.9) and burden (21.2 ± 11.3) , medication adherence challenges (21%) , and moderately strong self-efficacy (56.0 ± 15.1) . Correlations revealed time since diabetes diagnosis (r= -.11, p<.05) , social support (r= -.28, p<.001) , and self-efficacy (r= -.34, p<.001) were inversely associated with distress. While unemployment (r=.13, p<.05) , A1c (r=.19, p<.05) , more social needs (r=.12, p<.05) , worse self-rated health (r=.32, p<.001) , more stress (r=.16, p<.05) and depression (r=.52, p<.001) , more comorbidities (r=.28, p<.001) and burden (r=.41, p<.001) , and poor medication adherence (r=.19, p<.001) were positively correlated with distress. A multiple linear regression model explained 36% of the variance in distress. Significant factors of distress were less time since diabetes diagnosis (β=-.04, p<.05) , higher A1c (β=.94, p<.05) , higher depression (β=.57, p<.001) , more comorbidity burden (β=.06, p<.001) , and lower self-efficacy (β=-.04, p<.001) . Findings suggest key modifiable factors that may increase distress, warranting research examining strategies to screen and address such factors to improve diabetes self-management.