Stability and impact of diabetes distress over time: The potential value and uses of the type 1 diabetes distress assessment system (T1-DDAS)

Diabet Med. 2025 Jul;42(7):e70066. doi: 10.1111/dme.70066. Epub 2025 May 8.

Abstract

Aims: To document stability and change over time, define a minimal clinically important difference (MCID), and examine the predictive validity of the new Type 1 Diabetes Distress Assessment System (T1-DDAS).

Methods: A total of 574 adults with type 1 diabetes recruited through national registries and previous studies completed the T1-DDAS Core and Source scales alongside a report of insulin taking and glycaemic measures at baseline and 6 months later.

Results: The MCID for the T1-DAS is ±0.27. T1-DDAS scores were highly stable over 6 months: 88% of individuals with elevated Core Diabetes Distress (DD) in the study continued to report elevated DD at or above the 2.0 threshold 6 months later; 57% reported no improvement or a worsening in Core DD based on MCID. Elevated DD at baseline was linked to worsening in reported missed insulin bolus taking and HbA1c at 6 months.

Conclusions: Findings add to our understanding of DD and the utility of the T1-DDAS by demonstrating the stability and predictive validity of the T1-DDAS Core and Source scales to assess DD.

Keywords: diabetes distress; emotion; type 1 diabetes.

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1* / drug therapy
  • Diabetes Mellitus, Type 1* / psychology
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Minimal Clinically Important Difference
  • Psychological Distress*
  • Reproducibility of Results
  • Stress, Psychological* / diagnosis
  • Stress, Psychological* / etiology
  • Young Adult

Substances

  • Insulin
  • Glycated Hemoglobin
  • Hypoglycemic Agents
  • Blood Glucose