Type 1 diabetes-specific distress among adults with type 1 diabetes in Japan

The prevalence and characteristics of diabetes distress (DD) in Japanese adults with type 1 diabetes mellitus (T1D) remain unclear. Therefore, this study aimed to investigate the prevalence and associated features of DD in this population. A cross-sectional study was conducted using the Type 1 Diabetes Distress Scale (T1-DDS), the Problem Areas in Diabetes (PAID) scale, and the Hypoglycemia Fear Survey (HFS). Data from 117 adults with T1D were analyzed. Group comparisons were made using t-tests and anova, and associations were assessed using Spearman's rank correlation. Confirmatory factor analysis (CFA) was used to examine the structure of the T1-DDS.

Of the 144 screened participants, 117 (mean age: 50.6 ± 12.8 years; 44.4% male; mean diabetes duration: 18.1 ± 10.7 years; mean HbA1c: 7.6% ± 0.9%) were included in the analysis. Moderate and high DD were observed in 30.8% and 16.2%, respectively. Participants with high DD had significantly higher PAID and HFS-Worry/Behavior scores, despite no significant differences in age, sex, diabetes duration, or HbA1c. Among T1-DDS subscales, Powerlessness and Eating Distress had the highest mean scores. All subscale scores were correlated with total distress (rho = 0.636-0.916) and showed good internal consistency (Cronbach's alpha = 0.784-0.875). CFA supported the seven-factor structure with marginal-to-acceptable model fit.

DD is prevalent in Japanese adults with T1D. The T1-DDS can be a useful screening tool for identifying individuals experiencing diabetes-related emotional burden and guiding personalized interventions for these individuals.