Lyengar, J, Steenkamp, D, Abdel-Hadi, M, Buckingham, D, Hannon, T, Joarder, F, Rioles, N, Semenkovich, K, Tweet, R, Vora, D, Yardley, H, Roberts, A.

Introduction and Objective: The American Diabetes Association’s Standards of Medical Care in Diabetes recommend routine screening for diabetes distress (DD) in persons with type 1 diabetes (PwT1D). Evidence consistently demonstrates that DD significantly impacts glycemic outcomes, self-care behaviors, and overall well-being. However, the extent to which screening has been implemented in clinical practice remains uncertain. Here, we evaluate DD screening practices within the T1D Exchange Quality Improvement Collaborative (T1DX-QI) network.

Methods: The T1DX-QI network comprises 62 U.S.-based pediatric and adult endocrinology and diabetes centers that use data-driven, evidence-based strategies to improve outcomes for PwT1D. As part of the 2024 annual survey, centers were asked about their DD screening practices.

Results: Between September 9th and November 5th, 2024, 19 of 22 (86%) adult centers and 38 of 40 (95%) pediatric centers completed the survey for an overall response rate of 92%. Twenty centers (35%) reported screening for DD in PwT1D or their parents. Pediatric centers (16/38; 42%) were more likely to screen for DD than adult centers (4/19; 21%). Most pediatric centers (13/16) use a version of the Problem Areas in Diabetes (PAID) Scale whereas most adult centers (3/4) use the Type 1 Diabetes Distress Assessment System (T1-DDAS). Only 8 pediatric and 1 adult center report screening >50% of their PwT1D annually.

Conclusion: Despite recommendations for routine DD screening and the existence of validated screening tools, just over one-third of T1DX-QI centers (20/57) engaged in any form of DD screening, and only 16% (9/57) screened more than half of their T1D population annually. Our findings highlight a critical gap in routine psychosocial care for PwT1D. Future quality improvement work is needed to integrate DD screening as a standard component of comprehensive diabetes management and ensure timely identification and support for those experiencing DD.

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