OBJECTIVES: High levels of diabetes distress can lead to reduced quality of life and increased likelihood of incident depression. The aim of this study was to measure the level of diabetes distress in France and analyze potential independent risk factors for elevated diabetes distress.

METHODS: We conducted a patient-centered cross-sectional survey from April to July 2022, including 280 people with diabetes (T1D n=130; T2D n=150) living in France. Diabetes distress was measured using the PAID-5 questionnaire. As predictors of diabetes distress, age, sex, type of diabetes, duration of diabetes, health status, treatment regimen and co-morbidities were included in a multivariate regression analysis after weighting the sample according to the age distribution of the French population (INSEE report 2021).

RESULTS: The mean PAID-5 score (11.3 ±4.3) was rather high, corresponding to a total PAID-20-score of 56. Elevated PAID scores (Paid Score ≥ 40) were present in 68.1% of the sample. Regression analysis showed that in total 27.1% of the variance of PAID scores could be explained by the chosen predictors. Elevated PAID scores were negatively associated with age (ß=-0.21, p<.001 DR² 2.4%), treatment satisfaction (ß=-0.21, p<.001 DR² 8.4%), and self-reported health status (ß=-0.34, p<.001 DR² 8.8%). Non-significant predictors were sex (ß=0.05, p=.964), diabetes duration (ß=0.10, p=.075), diabetes type (ß=-0.12, p=.082), treatment intensity (ß=0.01, p=.903), non-diabetes-specific complications (ß=0.03, p=.563) and diabetes-related complications (ß=0.1, p=.062).

CONCLUSIONS: We identified a high proportion of people with elevated diabetes distress scores. A significant proportion of the variance in the PAID-Score could be explained by the selected predictors. The main independent predictors of increased distress were lower perceived health and treatment satisfaction and younger age, which combined explained 19.8% of the PAID score. Diabetes distress is influenced by perceived health status and satisfaction with diabetes care, rather than by objective medical diagnosis or diabetes therapy.