628-P: Symptoms of Autonomic Nervous System Dysregulation and Diabetes Distress in T2D Adults Free

Purpose: To test the association of autonomic nervous system (ANS) dysregulation symptoms and diabetes distress (DD) in adults with type 2 diabetes (T2D). US adults (n=299) with self-identified type 2 diabetes completed a web-based survey in October 2022, including demographics, ANS reactivity symptoms (Body Perception Questionnaire; BPQ), diabetes-related distress (Diabetes Distress Scale-17; DDS-17), depressive symptoms (PHQ-8) and anxiety (GAD-7). Mean age was 60.2 years (S.D. = 13.6), 58.7% female, 82.9% White, with a median annual household income of $40,000-$60,000. Mean self-reported A1c was 7.0% (S.D. 1.2%). Self-reported medications: oral hypoglycemic agents (51.8%), oral medications and injectable insulin or other medications (26.7%), and diet and exercise alone (8.4%). Mean glucose checks was 1.5 times/day (S.D. = 4.9). The sample reported high levels of comorbid hypertension (65.4%), dyslipidemia (55.8%), sleep apnea (33.9%) and depression (36.2%). Mean DDS-17 score was 2.3 (S.D. 1.0; moderate severity). The highest scores were observed in the emotional burden (mean = 2.6; S.D. 1.3) and regimen-related distress (mean = 2.7; S.D. 1.2) subscales. Mean PHQ-8 score was 6.7 (S.D. = 6.0; mild) and the mean GAD-7 score was 4.74 (S.D. 5.6, mild). BPQ mean T scores were 49.9 (S.D. 9.4) for Supradiaphragmatic and 52.0 (S.D. 8.8) for Subdiaphragmatic Reactivity subscales. Positive correlations between the DDS-17 and BPQ subscales (range: r=0.53-0.58, all p’s<.05) were observed. Controlling for covariates, significant differences in BPQ subscale T scores were observed across clinical severity levels of the DDS on all subscales, with the highest BPQ scores observed in the ‘high’ distress DDS category compared to ‘no/mild distress’ (p’s < 0.05). Findings confirm a relationship between ANS reactivity symptoms and diabetes-related distress, consistent with the Polyvagal Theory. Development of interventions that target ANS regulation to treat DD for T2D adults are needed.