The association between problem areas in diabetes scale scores and glycemic control is modified by types of diabetes therapy: diabetes distress and care registry in Tenri (DDCRT 2)

Diabetes Res Clin Pract. 2012 Sep;97(3):405-10. doi: 10.1016/j.diabres.2012.04.005. Epub 2012 May 1.


Aim: To evaluate the joint association of Problem Areas in Diabetes (PAID) Scale scores and glycemic control with diabetes therapy.

Methods: We used 3479 patients' data with type 1 and type 2. Modified Poisson regression analysis was used to estimate relative risks (RRs) for poor glycemic control (HbA1c≥7.0%) across quartiles of PAID scores.

Results: Compared with the 1st quartile of PAID score, multivariable-adjusted RRs for poor glycemic control were 0.99 (95%CI, 0.87-1.11), 1.05 (95%CI, 0.93-1.18), and 1.12 (95%CI, 1.00-1.27), respectively, for 2nd to 4th quartiles, and we observed significant trend (p for trend=0.03). We observed significant interaction of PAID score and HbA1c with diabetes therapy (p=0.0469). In patients receiving diet only therapy, the RRs for poor glycemic control were 1.38 (95%CI, 0.93-2.05), 1.18 (95%CI, 0.51-5.13), and 1.81 (95%CI, 1.16-2.79), respectively for 2nd to 4th quartiles of PAID score compared with the 1st quartile (p for trend=0.025); while we did not observe significant association between PAID and poor glycemic control in patients receiving medication therapy.

Conclusions: Diabetes distress measured by PAID survey was associated with poor glycemic control, and this association was modified by diabetes therapy.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Glucose / physiology*
  • Diabetes Complications / classification
  • Diabetes Complications / diagnosis
  • Diabetes Complications / epidemiology
  • Diabetes Complications / therapy*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / classification*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / therapy*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Japan / epidemiology
  • Male
  • Medical Records, Problem-Oriented / statistics & numerical data
  • Middle Aged
  • Registries* / statistics & numerical data
  • Regression Analysis
  • Research Design
  • Societies, Medical


  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human