Diabetes Distress Is High and Negatively Affects Diabetes Control in Kidney Transplant Recipients (KTR): A Prospective Study

Background: Impact of diabetes distress (DDS) on type 2 diabetes (T2D) control in KTR is unknown. Validated T2D DDS questionnaire includes emotional, physician-related, management related, and interpersonal distress components (17 points). Total scores>2 and ≥3 in each component indicate moderate and severe DDS, respectively. Methods: We prospectively assessed DDS in 21 KTR at mean time of 2.1 (1.5) y post KT. Glucose control was assessed by Continuous glucose monitoring (CGM) metrics (Dexcom G6) worn for ten days and HbA1C. Results: Table 1 depicts demographics and Figure 1 glucose metrics. Treatment regimens: Median DDS scores were 7 (IQR 5,13), 4 (IQR4,4), 8 (IQR 5,11), and 3 (IQR 3,5) for emotional, physician, treatment regimen, and interpersonal subscale, respectively. CGM metrics showed mean time in range (TIR; goal>70%) of 42.6 (25.2) %, and mean time in hyperglycemia of 57.4 (25.2) %. Treatment distress correlated with higher mean glucose (rs=0.44; p=0.04) and lower TIR (rs=-0.45; p=0.04) and higher HbA1c (latter in pts with no anemia) (rs=0.62; p=0.003). No correlation was found between HbA1c and CGM metrics. Conclusion: KTR with T2D experience high DDS, which negatively impact glucose control. Efforts should be focused on reducing treatment burden. Funding: Commercial Support - DEXCOM, Private Foundation SupportDemographics - Mean age (yrs) 61.7 (9.1) BMI(Kg/m2) 32.4 (3.9) Mean glucose (mg/dL)* 212 (64.4) Hb (%) 7.8 (1.4) Normal Hb (N) 16 (69.5%) On Insulin (N) 8 (34.7%) On Insulin + other anti-hyperglycemic (N) 13 (56.5%) On non-insulin (N) 2 (8.7%)