title: 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).
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan. hayasino-y@umin.net
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Hayashino
authors.forename: Shintaro
authors.initials: S
authors.lastname: Okamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsunaga
authors.forename: Satoru
authors.initials: S
authors.lastname: Tsujii
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishii
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000502:physiology*; D048909:Diabetes Complications / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003920:Diabetes Mellitus / Q000097:blood / Q000145:classification* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008501:Medical Records, Problem-Oriented / Q000706:statistics & numerical data; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D012044:Regression Analysis; D012107:Research Design; D012955:Societies, Medical
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human