Insulin Dependence and Poor Glycemic Control Drive Diabetes Distress, finds study
Insulin dependence and poor glycemic control were identified as major contributors to diabetes distress (DD). Addressing these factors is crucial for improving both glycemic management and psychosocial outcomes in this population. The study was published in the journal of Clinical Transplantation by Ishola FA and colleagues.
In order to identify predictors of burnout syndrome among members of this unique population of surgeons, a research team comprised of clinicians performed an analysis of registry data that had been collected over several years. The researchers examined 124 patients involved in the LIFT cohort – the Long-Term Islet Function and Impact after TPIAT – focusing specifically on subjects who had undergone their surgery 5 to 20 years ago. The research team collected comprehensive metrics on conventional insulin doses, clinical evidence of graft function based on measurements of C-peptide, CGM outcomes, and a history of acute metabolic complications.
Diabetes distress measures were measured via psychometric tools and compared through independent t-tests. Next, the research team performed multivariable linear regression analyses with robust adjustment for key demographic factors.
Key findings:
- The selected population for analysis includes 73% female subjects with a median age of 47 years old.
- This population has a steady median HbA1c rate of 6.6%, as well as 81% of the patients successfully reaching more than 50% CGM time in range (TIR).
- Functionality of transplanted islets in terms of biological activity with a C-peptide level of 0.6 ng/mL or more has been confirmed in 92% of the studied patients, thus ensuring that 31% of the entire study population becomes completely independent from external insulin use.
- The group of people who remain or become insulin-dependent demonstrates statistically significant higher diabetes distress scores, as their mean is 1.78 ± 0.70, which is substantially higher compared to the insulin-independent group with 1.52 ± 0.64 as an average value (p = 0.043).
- Insulin-dependent patients who spend less than 50% of their daily period in a safe range (TIR < 50%) have a high mean diabetes distress score, being 2.10 ± 0.76 as opposed to the steady score of 1.57 ± 0.70 among people with TIR > 70% (p = 0.021).
Insulin dependency and lack of glycemic regulation play a vital role in DD. It is crucial to solve this issue in order to have positive results both for the glycemic and psychological state of the patients. The long-term effects of the LIFT study show clearly that traditional transplant treatment ignores an important aspect of care for people with DD – their islet cell survival should not be considered if the patient suffers emotionally.
Reference:
Ishola, Faidat Adeola, et al. "Poor Glycemic Status Is Associated With Diabetes Distress After Total Pancreatectomy With Islet Autotransplantation." Clinical Transplantation, vol. 40, no. 5, 2026, pp. e70573.
