T1-REDEEM: A Randomized Controlled Trial to Reduce Diabetes Distress Among Adults With Type 1 Diabetes

Abstract

DD can be successfully reduced among distressed individuals with T1D with elevated HbA using both education/behavioral and emotion-focused approaches. Reductions in DD are only modestly associated with reductions in HbA. These findings point to the importance of tailoring interventions to address affective, knowledge, and cognitive skills when intervening to reduce DD and improve glycemic control.

Addressing diabetes distress in clinical care: a practical guide

“…We have found that best results are achieved when diabetes distress is targeted directly for intervention, rather than indirectly through programmes of education or lifestyle change . Although diabetes distress in most cases should, in our view, be attended to in most or all clinical encounters , there are occasions during which attention to diabetes distress may provide particularly added value.…”

“…These findings suggest that reductions in diabetes distress as a result of intervention may not, in and of themselves, lead directly to significant improvements in self‐management or glycaemic control . It may be the case that elevated diabetes distress serves as a barrier that prevents responsiveness to interventions to improve self‐management and glycaemic control: high diabetes distress constrains energy and reduces motivation to engage meaningfully in self‐care tasks . Reducing diabetes distress, however, may allow individuals with diabetes to become more responsive to programmes that target specific management or glycaemic goals.…”

“…There is an important distinction to be made between cross‐sectional associations between diabetes distress and self‐management or HbA 1c at one point in time, and how change in diabetes distress through intervention affects change in management or HbA 1c over time. Two studies, one including adults with Type 1 and the other with Type 2 diabetes, highlight this distinction . Both showed significant and clinically meaningful cross‐sectional associations between diabetes distress and self‐management and HbA 1c at baseline, prior to intervention.…”

Biopsychosocial Factors Associated With Satisfaction and Sustained Use of Artificial Pancreas Technology and Its Components: a Call to the Technology Field

“…Diabetes distress comprises the emotional burdens, stresses, and worries that may result from managing T1D [67], which have been shown to decrease in adults with T1D who use CGMs [37]. Importantly, CGM use has also been shown to not worsen diabetes distress in adolescents [68].…”

Learning about Type 1 diabetes and learning to live with it when diagnosed in adulthood: two distinct but inter‐related psychological processes of adaptation A qualitative longitudinal study

“…The narratives in some way revealed the hidden story of the lengthy process of adapting to diabetes by relaying personal diabetes journeys. The limited number of psychological interventions and resources deployed in diabetes, are currently used to support people with established diabetes [5,19,20]. The narratives also showed that important psychological and social adaptive processes took place in this early phase of diabetes such as: their psychological orientation to diabetes (acceptance/ rejection, anxiety/distress); their understanding of and confidence in self-management; and how they managed diabetes in social and work situations.…”