The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional Study

Background: Diabetes-related distress (DD) significantly impacts self-management and quality of life (QoL) in individuals with type 1 diabetes (T1D). While previous research has established a strong link between DD and glycemic control in type 2 diabetes, the relationship remains less consistent in...

Full description

Saved in:
Bibliographic Details
Main Authors: Antonia Losonczi, Csaba Kazinczi, Flora Fehervari, Mandorla Illenyi, Zoltan Herold, Dora Palmai, Adrien Rigo, Eva Varga, Zsofia Maria Zemplenyi, Agnes Vincze, Geza Nagy
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diabetology
Subjects:
Online Access:https://www.mdpi.com/2673-4540/6/3/19
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850204550349193216
author Antonia Losonczi
Csaba Kazinczi
Flora Fehervari
Mandorla Illenyi
Zoltan Herold
Dora Palmai
Adrien Rigo
Eva Varga
Zsofia Maria Zemplenyi
Agnes Vincze
Geza Nagy
author_facet Antonia Losonczi
Csaba Kazinczi
Flora Fehervari
Mandorla Illenyi
Zoltan Herold
Dora Palmai
Adrien Rigo
Eva Varga
Zsofia Maria Zemplenyi
Agnes Vincze
Geza Nagy
author_sort Antonia Losonczi
collection DOAJ
description Background: Diabetes-related distress (DD) significantly impacts self-management and quality of life (QoL) in individuals with type 1 diabetes (T1D). While previous research has established a strong link between DD and glycemic control in type 2 diabetes, the relationship remains less consistent in T1D. Additionally, continuous glucose monitoring (CGM) has been shown to improve glycemic outcomes, yet its effects on self-management and QoL are still debated. This study aimed to examine the relationship between DD, self-management efficacy (SME), and QoL in T1D, incorporating both physiological and behavioral indicators. Furthermore, differences between CGM-users and non-users were investigated. Methods: A cross-sectional study including 108 T1D patients was conducted. Participants completed several validated self-report measures, including the Diabetes Distress Scale (DDS), Diabetes Self-Management Questionnaire (DSMQ), and Audit of Diabetes-Dependent Quality of Life (ADDQoL-19). HbA1c levels and CGM usage were retrieved from medical records. Structural equation modeling (SEM) was used to examine the relationships between DD, self-management, and QoL. Results: Distress level (DDS) had a significant negative effect on SME (β = −0.47, <i>p</i> < 0.001), suggesting that higher distress levels are associated with lower self-management. In contrast, SME showed no significant impact on quality of life (β = 0.03, <i>p</i> = 0.779). However, the relationship between quality of life and distress was significant and negative (β = −0.37, <i>p</i> < 0.001), meaning that higher distress levels are linked to a lower quality of life. No significant differences in DD, SME, HbA1c, or QoL were found among CGM users and non-users. Conclusions: DD significantly impacts self-management and QoL in individuals with T1D. Therefore, incorporating PROs on DD and on behavioral aspects of self-management alongside HbA1c levels in clinical care is essential for optimizing treatment plans and improving physical health outcomes. While CGM technology facilitates glucose regulation, it does not inherently improve QoL, which is more closely linked to distress.
format Article
id doaj-art-ba2bc38434174cb3a385ff0a4faa4e44
institution OA Journals
issn 2673-4540
language English
publishDate 2025-03-01
publisher MDPI AG
record_format Article
series Diabetology
spelling doaj-art-ba2bc38434174cb3a385ff0a4faa4e442025-08-20T02:11:16ZengMDPI AGDiabetology2673-45402025-03-01631910.3390/diabetology6030019The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional StudyAntonia Losonczi0Csaba Kazinczi1Flora Fehervari2Mandorla Illenyi3Zoltan Herold4Dora Palmai5Adrien Rigo6Eva Varga7Zsofia Maria Zemplenyi8Agnes Vincze9Geza Nagy10Department of Psychiatry and Psychotherapy, Semmelweis University, H-1085 Budapest, HungaryDepartment of Psychiatry and Psychotherapy, Semmelweis University, H-1085 Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, H-1088 Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, H-1088 Budapest, HungaryDivision of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, H-1083 Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, H-1088 Budapest, HungaryDepartment of Personality and Health Psychology, Faculty of Education and Psychology, Eötvös Loránd University, H-1075 Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, H-1088 Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, H-1088 Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, H-1088 Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, H-1088 Budapest, HungaryBackground: Diabetes-related distress (DD) significantly impacts self-management and quality of life (QoL) in individuals with type 1 diabetes (T1D). While previous research has established a strong link between DD and glycemic control in type 2 diabetes, the relationship remains less consistent in T1D. Additionally, continuous glucose monitoring (CGM) has been shown to improve glycemic outcomes, yet its effects on self-management and QoL are still debated. This study aimed to examine the relationship between DD, self-management efficacy (SME), and QoL in T1D, incorporating both physiological and behavioral indicators. Furthermore, differences between CGM-users and non-users were investigated. Methods: A cross-sectional study including 108 T1D patients was conducted. Participants completed several validated self-report measures, including the Diabetes Distress Scale (DDS), Diabetes Self-Management Questionnaire (DSMQ), and Audit of Diabetes-Dependent Quality of Life (ADDQoL-19). HbA1c levels and CGM usage were retrieved from medical records. Structural equation modeling (SEM) was used to examine the relationships between DD, self-management, and QoL. Results: Distress level (DDS) had a significant negative effect on SME (β = −0.47, <i>p</i> < 0.001), suggesting that higher distress levels are associated with lower self-management. In contrast, SME showed no significant impact on quality of life (β = 0.03, <i>p</i> = 0.779). However, the relationship between quality of life and distress was significant and negative (β = −0.37, <i>p</i> < 0.001), meaning that higher distress levels are linked to a lower quality of life. No significant differences in DD, SME, HbA1c, or QoL were found among CGM users and non-users. Conclusions: DD significantly impacts self-management and QoL in individuals with T1D. Therefore, incorporating PROs on DD and on behavioral aspects of self-management alongside HbA1c levels in clinical care is essential for optimizing treatment plans and improving physical health outcomes. While CGM technology facilitates glucose regulation, it does not inherently improve QoL, which is more closely linked to distress.https://www.mdpi.com/2673-4540/6/3/19diabetes distresstype 1 diabetesquality of lifecross-sectional studyHungary
spellingShingle Antonia Losonczi
Csaba Kazinczi
Flora Fehervari
Mandorla Illenyi
Zoltan Herold
Dora Palmai
Adrien Rigo
Eva Varga
Zsofia Maria Zemplenyi
Agnes Vincze
Geza Nagy
The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional Study
Diabetology
diabetes distress
type 1 diabetes
quality of life
cross-sectional study
Hungary
title The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional Study
title_full The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional Study
title_fullStr The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional Study
title_full_unstemmed The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional Study
title_short The Relationship Between Quality of Life, Diabetes Distress, and Metabolic Control in Hungarian Type 1 Diabetic Patients: A Cross-Sectional Study
title_sort relationship between quality of life diabetes distress and metabolic control in hungarian type 1 diabetic patients a cross sectional study
topic diabetes distress
type 1 diabetes
quality of life
cross-sectional study
Hungary
url https://www.mdpi.com/2673-4540/6/3/19
work_keys_str_mv AT antonialosonczi therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT csabakazinczi therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT florafehervari therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT mandorlaillenyi therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT zoltanherold therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT dorapalmai therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT adrienrigo therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT evavarga therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT zsofiamariazemplenyi therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT agnesvincze therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT gezanagy therelationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT antonialosonczi relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT csabakazinczi relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT florafehervari relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT mandorlaillenyi relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT zoltanherold relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT dorapalmai relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT adrienrigo relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT evavarga relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT zsofiamariazemplenyi relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT agnesvincze relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy
AT gezanagy relationshipbetweenqualityoflifediabetesdistressandmetaboliccontrolinhungariantype1diabeticpatientsacrosssectionalstudy