Validation of a Questionnaire to Assess Emotional Impact of Treatment for Type 2 Diabetes (EIDTQ)

OBJECTIVES: The Emotional Impact of Diabetes Treatment Questionnaire – Status version (EIDTQ-status) was developed based on qualitative research with patients to assess the positive and negative emotional impact of a patient’s treatment for T2D. The purpose of this study was to assess the psychometric properties of the EIDTQ-status.

METHODS: Patients with T2D treated with a range of medications (oral medications, GLP-1 receptor agonists, tirzepatide, insulin) were recruited from eight US clinical sites. They completed the EIDTQ-status and additional measures administered for validity assessment. Analyses focused on item performance, subscale identification, development of a scoring algorithm, reliability, and validity.

RESULTS: The sample include 250 patients (mean age = 59.7y; 54.4% female). Based on item performance and exploratory factor analysis, 14 items were retained and categorized into three subscales: positive emotions (8 items), negative emotions (3 items), sense of control over diabetes, eating, and weight (3 items). The EIDTQ-status demonstrated good internal consistency reliability (Cronbach’s alphas of the three subscales: 0.92, 0.88, and 0.85). Test-retest reliability was also acceptable with no significant differences between administrations 7+2 days apart among stable patients (n=37; ICCs: 0.85, 0.67, and 0.62). Construct validity was supported via correlations with validated instruments (e.g., 0.48, 0.40, and 0.52 with DTSQ treatment satisfaction subscale; all p < 0.0001). The EIDTQ-status demonstrated known-groups validity by distinguishing among groups of patients that differed in reports of emotional status. The EIDTQ-status may differentiate between treatments. For example, compared to injectable semaglutide (n = 49), tirzepatide-treated patients (n = 58) had a significantly greater sense of control over diabetes, eating, and weight (p = 0.01).

CONCLUSIONS: The EIDTQ-status had strong factor structure with three subscales that demonstrated good reliability and validity. This questionnaire may be useful in clinical trials and observational research assessing the emotional impact of treatment for T2D.