A Short-Form Measure of Diabetes Distress Among Adults With Type 1 Diabetes for Use in Clinical Practice: Development and Validation of The T1-DDS-7

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OBJECTIVE Valid and reliable diabetes distress assessment is essential for identifying adults with elevated levels of concern and to guide targeted support. However, assessing diabetes distress must also be feasible in time-limited settings. We aimed to identify a short-form measure of the 28-item Type 1 Diabetes Distress Scale (T1-DDS-28) representing seven sources of type 1 diabetes distress that would be convenient for use in clinical practice. RESEARCH DESIGN AND METHODS Based on the evaluation of influence and importance by 14 experts in diabetes care and research, we identified the best-performing item within each of seven sources of diabetes distress included in the T1-DDS-28. To further validate the proposed short-form measure, we used survey data from 2,016 adults living with type 1 diabetes. Validity was examined by exploratory factor analysis, Cronbach’s a, test-retest reliability analysis, and correlations with other psychosocial measures. RESULTS We identified a short-form measure of the T1-DDS-28 consisting of seven items, each representing a source of diabetes distress. These items showed satisfactory reliability (factor loadings > 0.45; a = 0.82; test-retest correlation, r = 0.90) and validity (correlation with T1-DDS-28, r = 0.95; area under the curve = 0.91; sensitivity 93%; specificity 89%) when combined in the short-form scale (T1-DDS-7). CONCLUSIONS We propose the T1-DDS-7 as a valid and reliable measure for routine screening of diabetes distress among adults with type 1 diabetes. In case of elevated levels of diabetes distress, we recommend that a full-scale assessment and open dialogue follow the short-form measure before determining further treatment.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind46
Udgave nummer9
Sider (fra-til)1619-1625
Antal sider7
ISSN0149-5992
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Acknowledgments. The authors sincerely thank Lawrence Fisher, University of California, San Francisco, CA, for his constructive and valuable guidance regarding the development and evaluation of the short-form measure, the experts within diabetes care and research who contributed valuable information for this study, the people with type 1 diabetes who participated in the survey, and Jennifer Green, Caduceus Strategies, for editorial assistance. Funding. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Duality of Interest. M.N., L.E.J., P.L., K.O., V.S., K.N., and I.W. are employed at Steno Diabetes Center Copenhagen, a public hospital and research institution under the Capital Region of Denmark, which is partly funded by an unrestricted grant from the Novo Nordisk Foundation. The funders had no role in this work. V.S. received lecture fees from Sanofi. K.N. received funding to her institution for participating in advisory boards from Medtronic, Novo Nordisk, and Convatec and for lecturing from Sanofi, Novo Nordisk, Medtronic, and Dexcom. Her institution received funding for studies she performed from Zealand Pharma, RSP Systems, Novo Nordisk, Medtronic, and Dexcom. U.P.-B. has served on advisory boards and received lecture fees from Novo Nordisk and Sanofi. P.L. and I.W. own stocks in Novo Nordisk. No other potential conflicts of interest relevant to this article were reported. Author Contributions. M.N., I.W., L.E.J., V.S., D.H., and K.O. conceptualized the study. P.L., K.N., and U.P.-B. contributed to the study’s design, curation, and critical review. M.N. and K.O. undertook the data analysis and interpreted the data. M.N., I.W., and K.O. drafted the first manuscript. All authors critically reviewed, edited, and approved the final version of the manuscript. K.O. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Publisher Copyright:
© 2023 by the American Diabetes Association.

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