TOPLINE:
Elevated diabetes distress (DD) correlated with autonomic nervous system (ANS) dysregulation symptoms in adults with type 1 diabetes (T1D) or type 2 diabetes (T2D), with supradiaphragmatic and subdiaphragmatic symptoms being more pronounced in those experiencing high to moderate DD than in those with mild or no distress.
METHODOLOGY:
- DD, an emotional condition arising from the challenges of managing diabetes, can be better understood through polyvagal theory (PVT), which offers a unique understanding of emotional regulation via ANS pathways.
- Researchers assessed the relationship between ANS dysregulation symptoms and DD in patients with T1D or T2D.
- They included data from two web-based survey studies: One conducted in October 2023 included 556 adults with self-reported T1D (mean age, 45.1 years; 73.2% women), and the other conducted in June 2022 comprised 299 adults with self-reported T2D (mean age, 60.2 years; 58.7% women).
- DD was assessed using the Diabetes Distress Scale (DDS)-T1 for T1D and DDS-17 for T2D, including various subscales of emotional and personal distress. DDS mean item scores < 2, 2-2.9, and ≥ 3 indicated mild, moderate, and high/severe DD, respectively.
- ANS symptoms were assessed using the Body Perception Questionnaire (BPQ) T scores. The analysis focused on perceived body awareness, and supradiaphragmatic and subdiaphragmatic reactivity associated with DD.
TAKEAWAY:
- Among patients with T1D, the mean BPQ T score was 48.9 for the supradiaphragmatic reactivity subscale and 50.6 for the subdiaphragmatic reactivity subscale, while the mean DDS-T1 score was 2.3.
- In patients with T2D, the mean BPQ T score was 49.9 for supradiaphragmatic reactivity subscale and 52.0 for subdiaphragmatic reactivity subscale, with a mean DDS-17 score of 2.3.
- DD scores were positively correlated with all BPQ subscales in patients with T1D and patients with T2D (both P < .05).
- Among patients with T1D, those with high DD had 7.1 times higher body awareness scores, 7.8 times higher supradiaphragmatic scores, and 7.1 times higher subdiaphragmatic scores than those with no or mild DD (all P < .001). Similar findings were observed in patients with T2D who had high DD.
IN PRACTICE:
“This study adds evidence for the presence of physiologic symptoms of emotional regulation in DD,” the authors wrote.
“The observed findings suggest the PVT appears to be a promising neurophysiologic paradigm to understand the phenomenon of DD in adults with T1D and T2D,” they added.
SOURCE:
This study was led by Mary de Groot of the Indiana University School of Medicine in Indianapolis, Indiana. It was published online in Diabetes Care.
LIMITATIONS:
The generalizability of this study was limited by the utilization of convenience samples from individuals with relatively high socioeconomic status, access to computer-based surveys, and limited ethnic diversity. Self-reported data may have introduced reporting bias. Additionally, data collection at only one timepoint limited the assessment of longitudinal associations.
DISCLOSURES:
Funding for participant incentives was provided by Division of Endocrinology Diabetes and Metabolism, Department of Medicine, Indiana University School of Medicine. One author reported being a faculty consultant to Mediflix, Inc.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
