Differential Associations Between Diabetes Distress Subtypes and Diabetes-Dependent Quality of Life and the Buffering Effect of Online Support Among Young Adults With Type 1 Diabetes: A Cross-Sectional Analysis
Yujia Mo, Pey-Jiuan Lee, John Sideris, Steven Fox, Ngozi D. Nnoli, Jennifer K. Raymond, Gabrielle Granados, Jeanine Blanchard, Jaime D. Leite, Elizabeth A. PyatakOBJECTIVE
Diabetes-dependent quality of life (DDQoL) is a salient health outcome for young adults with type 1 diabetes (T1D), shaped by diabetes distress and social support. This cross-sectional analysis examines 1) how diabetes distress subtypes relate to DDQoL, 2) whether online support is associated with DDQoL, and 3) whether online support moderates the relationship between diabetes distress and DDQoL.
RESEARCH DESIGN AND METHODS
We analyzed baseline data from a clinical trial of young adults with T1D (age 18–30 years, diabetes duration >1 year, HbA1c ≥7.5%). Participants completed the Diabetes Distress Scale, the Audit of Diabetes-Dependent Quality of Life, and a study-designed questionnaire on online support. Univariate and multivariate linear regressions were conducted.
RESULTS
Among 209 young adults (66% female, mean [SD] age 24.3 [3.7] years, 42.6% Hispanic or Latinx ethnicity), higher total diabetes distress and subscale scores were significantly associated with poorer DDQoL (average weighted impact score, P < 0.001), with emotional distress showing the strongest negative association (β –0.60, P < 0.001). Online support was also associated with lower DDQoL (β −0.17, P = 0.016). In the adjusted model, online support moderated the impact of interpersonal distress on DDQoL (interaction β 0.23, P = 0.026). Female gender was associated with better DDQoL (β 0.14, P = 0.031) and confounded key associations.
CONCLUSIONS
These findings revealed the differential associations between diabetes distress subtypes and DDQoL and the moderating role of online support in reducing the negative impact of interpersonal distress, underscoring the need for interventions targeting emotional distress and optimizing online support for young adults with T1D.