Almost three million Americans are diagnosed with type 1 diabetes annually. Formerly known as juvenile diabetes, type 1 affects mostly children, but adults have also been diagnosed. Those with type 1 cannot produce their own insulin, a hormone that regulates sugar levels in the blood. Thus, they must inject insulin into their bodies to compensate for the absence.
When glycated haemoglobin, or HbA1c, levels in the blood are above average, patients are diagnosed with diabetes. After diagnosis, the lives for type 1 diabetics can be difficult to manage with all the daily insulin injections and careful diet monitoring. Such drastically adjusted schedules often take away from one's quality of life. This can lead to more health issues such as anxiety and depression. Led by Ragnhild Bjarkøy Strandberg, a study published in the September 2014 issue of Journal of Psychosomatic Research sought to determine if there was a relationship between the emotional distress revolving around diabetes and levels of hemoglobin A1c (HbA1c).
Studying Levels of Emotional Distress in Diabetics
Recruited from an outpatient clinic, 235 individuals from ages 18 to 69 with type 1 diabetes participated in the study. Of the sample, 135 were male and 100 were female. Blood samples were taken from all participants to measure HbA1c levels. The average HbA1c level for the sample was 8.1%—the average level for someone without diabetes ranges from 4.5% to 6.5%.
After HbA1c levels were recorded, Strandberg assessed levels of emotional distress using the following tools:
- Problem Areas in Diabetes Survey (PAID): 20-item survey assessing emotional responses.
- Diabetes Distress Scale (DDS): 17-item scale measuring emotional burdens, physician-related stress, regimen-related stress, and diabetes-related stress.
- Hospital Anxiety and Depression Scale (HADS): Two scales screening for psychiatric disorders.
- World Health Organization-5 Well-Being Index (WHO-5): Five positively worded items used to assess well-being in the past two weeks.
Type 1 Diabetes Causes An Emotional Burden
The PAID and DDS scores were significantly related to the levels of HbA1C. However, the HADS and WHO-5 showed no correlation. “This study appears to be the first to demonstrate that among adults with type 1 diabetes, depression, anxiety, and overall well-being were not significantly related with glycemic control but there were significant associations between diabetes-specific emotional distress and HbA1c," concludes Strandberg. These findings suggest that “addressing distress related to the treatment regimen and self-care demands might give health care providers information necessary to assist the person in bettering their diabetes self-management."
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Ragnhild Bjarkøy Strandberg, Marit Graue, Tore Wentzel-Larsen, Mark Peyrot, Berit Rokne. Relationships of diabetes-specific emotional distress, depression, anxiety, and overall well-being with HbA1c in adult persons with type 1 diabetes. Journal of Psychosomatic Research, September 2014; DOI: 10.1016/j.jpsychores.2014.06.015
Date of original publication: September 06, 2014
Updated: October 23, 2015