690-P: Relationship of Diabetes Distress and Symptoms of Autonomic Nervous System Dysregulation in Type 1 Diabetes Adults

Purpose: To test the association of autonomic nervous system (ANS) dysregulation symptoms and diabetes distress (DD) in type 1 diabetes (T1D) adults. 556 US adults with self-identified T1D completed a web-based survey in May 2023, including demographics, ANS reactivity symptoms (Body Perception Questionnaire; BPQ, validated against physiologic measures), diabetes-related distress (Diabetes Distress Scale-28 T1D; DDS), depressive symptoms (PHQ-8) and anxiety (GAD-7). Mean age was 45. 1 years (S. D. = 15. 7), 73. 2% female, 95. 3% White, with a median annual household income of 60, 000-100, 000. Mean self-reported A1c was 6. 7% (S. D. 1. 0%). 72. 5% reported using an insulin pump. Mean hypoglycemic episodes per week was 5. 7 (9. 9). Mean age at diabetes diagnosis was 20. 6 years (S. D. 14. 7) and mean duration of diabetes was 25. 4 (S. D. 17. 6) years. The sample reported high levels of comorbid hypertension (33. 0%), dyslipidemia (28. 6%), thyroid disorder (34. 5%) and depression (28. 8%). Mean total item DDS score was 2. 3 (S. D. 0. 8; moderate severity). The highest scores were observed in the powerlessness (mean = 3. 2; S. D. 1. 3), hypoglycemia distress (mean = 2. 7, S. D. 1. 3) and physician distress (mean = 2. 4; S. D. 1. 2) subscales. Mean PHQ-8 score was 6. 8 (S. D. = 5. 5; mild) and the mean GAD-7 score was 5. 9 (S. D. 5. 3, mild). BPQ mean T scores were 48. 9 (S. D. 8. 4) for Supradiaphragmatic and 50. 6 (S. D. 8. 9) for Subdiaphragmatic Reactivity subscales. Controlling for covariates, clinical categories of the DDS predicted significant differences in BPQ subscale T scores. Greatest differences in BPQ scores were observed between ‘no/little/low’ and ‘high’ distress DDS categories on all subscales (p’s = 0. 001), with ‘high’ DDS having the highest BPQ scores. Findings confirm a relationship between ANS reactivity symptoms and diabetes-related distress in adults with T1D, consistent with the Polyvagal Theory. Development of interventions that target ANS regulation to treat DD for T1D adults are needed. Disclosure M. de Groot: None. B. A. Myers: None. T. Stump: None. D. Dana: None. J. Kolacz: None. S. W. Porges: None. Funding Indiana University School of Medicine