Objective: Although diabetes distress (DD) is common among young adults with type 1 diabetes (T1D), little is known about how to prevent DD. We determined whether greater environmental mastery is associated with a lower prevalence of DD.
Methods: In 2017, an online survey was completed by 423 of 743 (56.9%) young adults (19-31 years) with T1D receiving care at a specialty clinic in New York City. The prevalence of DD (score <u>></u>3) was measured with the 17-item Diabetes Distress Scale, and environmental mastery scores were measured with the 7-item subscale from Ryff’s Psychological Well-Being Scale. Logistic regression was used to adjust for sociodemographic and clinical covariates.
Results: Of the 416 respondents with complete DD and environmental mastery data, 59.1% were female, 62.7% used an insulin pump, and 47.6% used continuous glucose monitoring. Mean (SD) HbA1c was 8.0 (1.7)%, and 24.3% had DD. The covariate-adjusted prevalence (95% CI) of DD decreased across tertiles (sample-defined) of increasing environmental mastery: 49.6% (41.2%, 58.0%), 19.1% (12.8%, 25.3%), 6.5% (2.5%, 10.6%). This graded association was present across levels of HbA1c (Figure).
Conclusion: Greater environmental mastery was associated with lower DD and may protect young adults with T1D from developing DD.
K. Nagel: None. T. Dearth-Wesley: None. A.N. Herman: None. R.C. Whitaker: None.
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health (T32DK007028)
