Clinically-meaningful cut-points for diabetes distress among adolescents with type 1 diabetes

A new publication from the ACBRD highlights the high proportion of adolescents with type 1 diabetes who experience clinically-significant diabetes distress.

by Virginia Hagger


Studies in adults have reported high levels of emotional distress related to living with type 1 and type 2 diabetes. Diabetes distress characterises the ongoing emotional burden of managing diabetes, including feelings of frustration, worry and helplessness. The prevalence of diabetes distress among adolescents was previously uncertain, due to the absence of validated cut-points for age-appropriate measures.

This study by ACBRD researchers Virginia Hagger, Dr Christel Hendrieckx, Prof Jane Speight, and colleagues recently published in Diabetes Care, included 537 adolescents aged 13 to 19 years, who took part in the national Diabetes MILES Youth survey. Diabetes distress was measured with the Problem Areas in Diabetes-Teen (PAID-T), a brief questionnaire reflecting diabetes-related concerns specific to adolescents’ age and life-stage. The relationships between the PAID-T and depressive symptoms, self-reported HbA1c and self-monitoring of blood glucose (SMBG), were examined in order to establish clinically meaningful cut-points for diabetes distress.

Two cut-points were found to distinguish between three levels of severity: none-to-mild (<70), moderate (70–90), and high (>90) diabetes distress. Over half of the adolescents reported at least moderate distress (18% moderate; 36% high distress). Compared to adolescents with none-to-minimal distress, those with greater distress had significantly higher self-reported HbA1c and more severe depressive symptoms, and performed SMBG less frequently.

Using these cut-points, clinicians and researchers will now be able to identify young people who could potentially benefit from self-management support and enable evaluation of interventions aimed at reducing diabetes distress.

Hagger V, Hendreickx C, Cameron F, Pouwer F,  Skinner T, Speight J. Cut Points for Identifying Clinically Significant Diabetes Distress in Adolescents With Type 1 Diabetes Using the PAID-Teen: Results From Diabetes MILES Youth–Australia. Diabetes Care; doi.org/10.2337/dc17-0441

The Diabetes MILES Youth Study was funded by the National Diabetes Services Scheme, an initiative of the Australian Government, administered with the support of Diabetes Australia.