Purpose: It is well known that children, adolescents, and young adults with diabetes face numerous obstacles to adherence. Diabetes distress can lead to diabetes burnout, which worsens diabetes nonadherence. We initiated diabetes distress screening to determine the impact of diabetes distress on our patients and developed games and animated videos in an attempt to assess diabetes knowledge and decrease visit stress.

Methods: Diabetes patients aged 10 and older were given the two-question diabetes distress screening scale (DDS2) during their routine follow-up visits. Two games were created to play at the beginning of each appointment and two animated medical education videos were created on how to recognize and manage diabetes distress.

Results: A total of 207 patients received DDS2 screening questionnaires. The mean DDS2 score was 5.6 (Type 1, n=178) and 5.5 (Type 2, n=29) out of 12 possible points. Only a weak correlation was found between the DDS2 score and hemoglobin A1C (Type 1:R2=0.34, Type 2:R2=0.18) with essentially no correlation noted between diabetes duration and DDS2 score (Type 1:R2=0.001; Type 2:R2=0.01). Ninety-seven percent of patients liked the “pin the bone on your A1C” game, while 93% enjoyed the medical education quiz game, 80% felt they learned something from it, and 89% felt that it made them more relaxed for their visit.

Conclusions: Diabetes distress can lead to diabetes burnout, thus it is important to identify when present. Our data suggest that distress may sometimes be hidden, hence we should specifically screen for diabetes distress in all our pediatric patients that are tweens and older as no significant correlation was found between DDS2 score, hemoglobin A1C, and duration of diabetes. Therapy can be then directed to ameliorating the stress and burnout associated with living with diabetes while the use of easily created educational games and animated videos can be helpful adjuncts to assess patient knowledge while simultaneously lessening appointment stress.


T.Imai: None. T.Nguyen: None. T.S.Stanic: None. D.Diaz: None. D.Lopez: None. R.Kinman: None.

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