The association of environmental mastery and diabetes distress among young adults with type 1 diabetes

Abstract

Aims: We determined whether a global measure of environmental mastery (EM) was associated with diabetes distress (DD) among young adults with type 1 diabetes (T1D). Methods: In 2017, an online survey was completed by 423 of 743 (57%) young adults (19–31 years) with T1D receiving care at a speciality clinic in New York City. Linear regression was used to examine the association between EM scores (7-item scale from Ryff's Scales of Psychological Well-Being) and DD scores (17-item Diabetes Distress Scale), adjusting for HbA1c levels and sociodemographic and clinical covariates. Results: Among the 416 participants with complete data on EM and DD, the mean (SD) age was 24.5 (3.2) years. Fifty-nine per cent were female and 70% were Non-Hispanic White. The mean HbA1c level was 64 (18) mmol/mol/8.0 (1.7) %, the mean EM score was 33.5 ± 8.7 and the mean DD score was 2.3 ± 1.0. For each 1 SD increase in EM score, there was a 0.51 SD decrease (95% confidence interval [CI]: 0.43, 0.59) in the covariate-adjusted DD score. This inverse association between EM and DD was of similar magnitude among those with HbA1c levels in the target range (<53 mmol/mol [<7.0%]) and those with HbA1c levels not in the target range. Conclusions: Greater EM was associated with lower DD. Reducing DD in young adults with T1D may require a better understanding of the developmental processes that lead to a sense of global mastery.