Cut Points Established for the Diabetes Distress Scale

Three patient subgroups ID'd based on associations between diabetes distress scale, diabetes variables

FRIDAY, Jan. 13 (HealthDay News) -- Using the curvilinear relationship between the 17-item Diabetes Distress Scale (DDS17) and diabetes variables (hemoglobin A1c [HbA1c], self-efficacy, diet, and physical activity), distress cut points can be established, according to a study published online Jan. 6 in Diabetes Care.

Lawrence Fisher, Ph.D., of the University of California in San Francisco, and colleagues investigated the association between the DDS17 and diabetes variables to establish clinically meaningful cut points for high distress. Participants included patients with type 2 diabetes recruited from two studies: 506 from study one and 392 from study two. Correlations were also assessed for the two-item DDS (DDS2).

The researchers identified significant quadratic effects between DDS17 and HbA1c, self-efficacy, diet, and physical activity in study one, and between DDS17 and HbA1c, self-efficacy, and diet in study two, with increases in distress associated with poorer outcomes. For all four variables, substantive curvilinear associations began at unexpectedly low levels of DDS17. There was a linear increase in the slope between scores 1 and 2, which was muted between 2 and 3, and then peaked between 3 and 4. Based on these associations, three patient subgroups were suggested: little or no distress (<2.0), moderate distress (2.0 to 2.9), and high distress (≥3.0).

"The degree and shape of these relationships suggest cut points on the DDS17 and the DDS2 for three patient subgroups: those with little or no distress, moderate distress, and high distress," the authors write.

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