Diabetes distress in Type 1 diabetes—a new measurement fit for purpose

Abstract

Aims: To examine and assess (1) the internal consistency and validity of a Danish translation of the Diabetes Distress Scale (DDS 17) among adults with Type 1 diabetes mellitus, (2) the properties of the brief version of DDS 17 and (3) cut points for the DDS 17. Methods: Cross‐sectional survey of 2419 adults with Type 1 diabetes mellitus. Validated scales and questions measured diabetes distress (DDS 17), diabetes empowerment (DES‐SF), healthy diet, physical activity, self‐rated health (SF‐12) and quality of life (WHOQ oL‐BREF). An electronic patient record provided information about glycaemic control (HbA 1c). We examined internal consistency, construct validity, subscale construction and cut points for determining clinically relevant diabetes distress, as well as two‐ and four‐item brief versions of the DDS 17. Results: The DDS 17 had a Cronbach's alpha of 0.92; subscale alphas were 0.83–0.89. A four‐factor division into subscales was appropriate and the division corresponded closely to the four domains described in the development of the DDS 17. The DDS 17 correlated well with relevant measures; higher distress was correlated with low diabetes empowerment, low quality of life, unhealthy diet, not being physically active, poor glycaemic control and low scores on the mental component score of the SF‐12. A two‐item brief scale performed as well as a four‐item version. The relationship between DDS 17 and outcomes did not suggest distinct cut points for DDS 17. Conclusions: Our results provide support for the use of this Danish adaptation of the DDS 17 for assessing psychosocial distress among adults with Type 1 diabetes mellitus.