Examining the Relationship Between Diabetes Distress and Patient Activation in Adults With Type 2 Diabetes

Purpose The purpose of the study was to examine the relationship between diabetes distress and various factors with patient activation among adults with type 2 diabetes. Methods Linear and nonlinear relationships were evaluated using hierarchical polynomial regression models. Diabetes distress was measured using the Diabetes Distress Scale (DDS-17), with its 4 subscales, including emotional burden and regimen-, physician-, and interpersonal-related distress. Patient activation was measured using the Patient Activation Measure (PAM-13). Results There was a weak linear association between total DDS-17 and PAM-13 scores ( R 2 = 2.8%, P = .003). Across all subscales, results revealed robust quadratic trends that accounted for large increases in variance above and beyond linear trends ( R 2 s = 8.6%-23.0%, P s < .001). Conclusions Results indicate a robust U-shaped relationship between diabetes distress and patient activation. These findings have the potential to inform treatment approaches for individuals with moderate to high diabetes distress and/or low patient activation.