The association between Problem Areas in Diabetes Scale scores and glycemic control is modified by types of diabetes therapy: Diabetes Distress and Care Registry in Tenri (DDCRT 2)

Aim: To evaluate the joint association of Problem Areas in Diabetes (PAID) Scale scores and glycemic control with diabetes therapy. Methods: We used 3479 patients' data with type 1 and type 2. Modified Poisson regression analysis was used to estimate relative risks (RRs) for poor glycemic control (HbA1c >= 7.0%) across quartiles of PAID scores. Results: Compared with the 1st quartile of PAID score, multivariable-adjusted RRs for poor glycemic control were 0.99 (95% CI, 0.87-1.11), 1.05 (95% CI, 0.93-1.18), and 1.12 (95% CI, 1.00-1.27), respectively, for 2nd to 4th quartiles, and we observed significant trend (p for trend = 0.03). We observed significant interaction of PAID score and HbA1c with diabetes therapy (p = 0.0469). In patients receiving diet only therapy, the RRs for poor glycemic control were 1.38 (95% CI, 0.93-2.05), 1.18 (95% CI, 0.51-5.13), and 1.81 (95% CI, 1.16-2.79), respectively for 2nd to 4th quartiles of PAID score compared with the 1st quartile (p for trend = 0.025); while we did not observe significant association between PAID and poor glycemic control in patients receiving medication therapy. Conclusions: Diabetes distress measured by PAID survey was associated with poor glycemic control, and this association was modified by diabetes therapy. (C) 2012 Elsevier Ireland Ltd. All rights reserved.