Recurrent Diabetes‐Related Hospital Admissions and Diabetes Distress: Real‐World Evidence From the Association of British Clinical Diabetologists ( ABCD ) National Freestyle Libre Audit

AIMS: To evaluate the association between prior diabetes-related hospital admissions and diabetes distress and determine whether structured diabetes education modifies this relationship. MATERIALS AND METHODS: We analysed 14 460 adults from the Association of British Clinical Diabetologists (ABCD) National FreeStyle Libre Audit. High diabetes distress was defined using the two-item Diabetes Distress Scale (DDS-2; mean score ≥ 3). Diabetes-related hospital admissions during the preceding 12 months were categorised as none, single or recurrent (≥ 2). Multivariable logistic regression examined associations between admissions and distress after adjustment for demographic and clinical factors. Interaction between admissions and structured education was assessed using likelihood ratio testing. RESULTS: Participants had a mean age of 42.3 ± 18.1 years, 47.7% were female and most had type 1 diabetes. High diabetes distress was present in 51.5% of participants. In the complete-case cohort (n = 8017), recurrent diabetes-related admissions were independently associated with high diabetes distress (adjusted odds ratio [aOR] 1.94, 95% CI 1.48-2.57), whereas single admissions were not. Recurrent non-diabetes admissions were not independently associated with distress. Significant interaction was observed between admissions and structured education (p < 0.001). Among individuals with recurrent admissions, distress prevalence was lower among those reporting structured education (64.1% vs. 80.4%). Hypoglycaemia-related and other diabetes-related admissions were independently associated with distress. CONCLUSIONS: Recurrent diabetes-related hospital admissions are strongly associated with diabetes distress, with the independent association driven by recurrent rather than isolated events. Lower distress among individuals reporting structured education supports further evaluation of integrated psychosocial and educational approaches following acute diabetes-related hospital admission.