Stability and impact of diabetes distress over time: The potential value and uses of the type 1 diabetes distress assessment system ( T1 ‐ DDAS )

AIMS: To document stability and change over time, define a minimal clinically important difference (MCID), and examine the predictive validity of the new Type 1 Diabetes Distress Assessment System (T1-DDAS). METHODS: A total of 574 adults with type 1 diabetes recruited through national registries and previous studies completed the T1-DDAS Core and Source scales alongside a report of insulin taking and glycaemic measures at baseline and 6 months later. RESULTS: The MCID for the T1-DAS is ±0.27. T1-DDAS scores were highly stable over 6 months: 88% of individuals with elevated Core Diabetes Distress (DD) in the study continued to report elevated DD at or above the 2.0 threshold 6 months later; 57% reported no improvement or a worsening in Core DD based on MCID. Elevated DD at baseline was linked to worsening in reported missed insulin bolus taking and HbA1c at 6 months. CONCLUSIONS: Findings add to our understanding of DD and the utility of the T1-DDAS by demonstrating the stability and predictive validity of the T1-DDAS Core and Source scales to assess DD.