Title Association of diabetes technology use and diabetes distress in adults with type 1 diabetes
Title (croatian) Povezanost upotrebe tehnologije u liječenu osoba sa šećernom bolešću tipa 1 i distresa uzrokovanog šećernom bolešću.
Author Nataša Grulović
Mentor Maja Baretić (mentor)
Committee member Tina Tičinović Kurir (predsjednik povjerenstva)
Committee member Trpimir Glavina (član povjerenstva)
Committee member Damir Roje (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2023-12-19, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Universal decimal classification (UDC ) 616 - Pathology. Clinical medicine
Abstract Background: Type 1 diabetes (T1DM) is a chronic disease requiring lifelong insulin therapy and rigorous self-management. As it negatively impacts the affected individuals’ quality of life, it may eventually lead to diabetes distress, the emotional response to living with diabetes. While technology has enhanced diabetes management, there can also be subjective burdens and barriers to uptake. Objectives: The primary goal of this study was to investigate the relationship between the use of diabetes technology and diabetes distress among adults with T1DM. Secondary objectives included assessing the prevalence and predictors of diabetes distress. Material and methods: The research encompassed a multicenter, cross-sectional approach across several countries in South Eastern Europe. A total of 499 participants who fulfilled the eligibility criteria (diagnosed with T1DM for at least a year, aged 26 or older, with recent HbA1c data) were included in the study. They self-completed 20-item Problem Area in Diabetes (PAID) Questionnaire. A total PAID score of 40 or higher indicated significant diabetes distress. Results: The mean age of participants was 49.11 (SD 13.99) years, mean HbA1c 7.9% (SD 1.46) and mean PAID total score of 29.19 (SD 19.51). Diabetes distress was found in 29.2% of the participants. About 20% of participants adopted new diabetes technologies, including continuous glucose monitors, insulin pumps, and mobile applications. The study did not reveal a statistically significant association between the use of diabetes technology and diabetes distress. Significant predictors of diabetes distress did emerge; gender, body mass index (BMI), and HbA1c. Being male reduced odds of high diabetes distress by 46%. Each 1 kg/m2 increase in BMI led to a 5% increase in the likelihood of high distress, while every 1% increase in HbA1c raised the odds by 16%. After accounting for these predictors, technology use remained a significant factor and T1DM patients who embraced new technology exhibited a 42% lower chance of experiencing high diabetes distress, compared to those using traditional blood glucometers. The study also highlighted specific aspects contributing to distress. Concerns about the future, anxiety about chronic complications, coping with existing diabetes-related problems, and guilt stemming from deviations in diabetes management were identified as key drivers of distress. Conclusion: We found high prevalence of diabetes distress in the population of patients having T1DM. No statistical association between new technology use and diabetes distress was found, suggesting that the use of one or more new technologies does not add additional emotional burden in people living with T1DM. Sex, BMI and HbA1c were significant predictors of high diabetes distress, and new technology use predicts independently lower diabetes distress in such patients. The findings emphasize the need for personalized approaches that consider both technological interventions and psychosocial support to enhance the quality of life for individuals living with T1DM.
Abstract (croatian) Uvod: Šećerna bolest tipa 1 (T1DM) je kronična bolest kod koje je neminovna doživotna terapija inzulinom i svakodnevna samokontrola glikemije. T1DM smanjuje kvalitetu života oboljelih te kroz emocionalni odgovor na specifičan stil života može dovesti do distresa uzorkovanog šećernom bolešću. Unatoč tome što je razvoj tehnologije olakšao liječenje T1DM, korištenje tehnologije nekada predstavlja izazov te dodatno opterećenje radi težeg prihvaćanja novih uređaja. Ciljevi: Primarni cilj bio je istražiti odnos između upotrebe tehnologije u liječenju odraslih osoba s T1DM te distresa vezanog uz šećernu bolest. Sekundarni ciljevi uključivali su procjenu prevalencije distresa vezanog uz šećernu bolesti i identifikaciju njegovih prediktora. Ispitanici i metode: Radilo se o multicentričnoj, presječnoj studiji koja je provedena je u nekoliko zemalja jugoistočne Europe. Uključeno je 499 sudionika kojima je dijagnosticiran T1DM unazad najmanje godinu dana, koji su imali 26 godina ili više te kod kojih je bio dostupan podatak vrijednosti HbA1c. Ispitanici su samostalno ispunili Upitnik o problematičnim područjima šećernoj bolesti (engl. Problem Areas in Diabetes Questionnaire, PAID) od 20 čestica. Ukupan PAID rezultat od 40 ili više ukazuje na značajan distres vezan uz šećernu bolest. Rezultati: Srednja dob ispitanika bila je 49,11 (SD 13,99) godina, srednji HbA1c 7,9% (SD 1,46) i srednj ukupni rezultat PAID-a 29,19 (SD 19,51). Distres uzrokovan šećernom bolešću je nađen kod 29,2% sudionika. Ukupno 20% sudionika koristilo je u liječenju T1DM nove tehnologije, uključujući kontinuirano mjerenje glukoze, inzulinske crpke te mobilne aplikacije. Nije nađena statistički značajna povezanost između upotrebe tehnologije u liječenju T1DM i distresa uzorkovanog šećernom bolešću. Izdvojeni su i prediktori distresa uzrokovanog šećernom bolešću; spol, indeks tjelesne mase (ITM) i HbA1c. Osobe muškog spola imale su 46% manji rizik za pojavu distresa uzorkovanog šećernom bolešću, povećanje ITM-a za 1 kg/m2 dovelo je do 5% veće vjerojatnosti od navedenog distresa, a svaki je porast HbA1c od 1% povećao izglede za distres za 16%. Nakon anuliranja utjecanja navedenih prediktora, sama uporaba tehnologije ostala je značajan čimbenik te se pokazalo da bolesnici s T1DM koji su koristili novu tehnologiju imaju 42% manju vjerojatnost da će doživjeti distres uzrokovanog šećernom bolešću u usporedbi s onima koji koriste samo glukometre. Zasebno se izdvojeni uzroci nelagode koji najviše dopridonose distresu uzorkovanom šećernom bolešću; zabrinutost za budućnost, tjeskoba zbog kroničnih komplikacija, suočavanje s postojećim problemima povezanim s dijabetesom i krivnja koja nastaje radi loše regulacije T1DM. Zaključak: U studiji odraslih osoba s T1DM nađena je visoka prevalencija distresa uzrokovanog šećernom bolešću. Nije pronađena statistička povezanost između korištenja tehnologije u T1DM i distresa uzrokovanog šećernom bolešću, što sugerira da korištenje jedne ili više novih tehnologija dodatno emocionalno ne opterećuje pojedince s T1DM. Spol, ITM i HbA1c bili su značajni prediktori distresa uzrokovanog šećernom bolešću, a uporaba nove tehnologije neovisno o navedenim prediktorima predviđa niži distres uzorkovan šećernom bolešću u ispitivanoj populaciji. Rezultati upućuju na potrebu individualnog pristupa svakom bolesniku s T1DM uzimajući u obzir kako korištenje novih tehnologija tako i psihosocijalnu podršku za poboljšanje kvalitete života.
Keywords
distress
Type 1 diabetes
T1DM
diabetes technology
Keywords (croatian)
distres
šećerna bolest tipa 1
T1DM
tehnologija u liječenju šećerne bolesti
Language english
URN:NBN urn:nbn:hr:171:626372
Promotion 2024
Study programme Title: Translational Research in Biomedicine - TRIBE Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, interdisciplinarna područja znanosti (doktor/doktorica znanosti, interdisciplinarna područja znanosti)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-01-05 13:35:36