D-stress Study

Optimising the Delivery of Diabetes Distress-Informed Care for its Prevention, Detection and Management in Adults with Type 1 Diabetes: A Hybrid Effectiveness-Implementation Programme (D-stress Study) Diabetes distress is constituted by the negative emotions of living with diabetes and is associated with worse self-management behaviours and hyperglycaemia. National Institute for Health and Care Excellence acknowledges the importance of addressing diabetes distress and recommends routine assessments as part of diabetes care. Addressing diabetes distress is critical, as reducing it can improve patients' quality of life, promote better diabetes management, and lower long-term NHS expenses. Research shows that nearly half of all adults with type 1 diabetes experience high levels of diabetes distress, but there is limited knowledge on recognising and managing this condition, and no current treatment is available through the NHS. Researchers in the USA and Denmark have developed and tested three treatments to detect, manage and prevent type 1 diabetes distress. However, despite these treatments showing promise to reduce the impact of diabetes distress, they haven’t yet been tested in the UK. This novel study will combine the best of the three existing treatments through consultation with people with type 1 diabetes and healthcare professionals, testing the programme in a feasibility trial, running a larger trial across national diabetes clinics, and evaluating who D-stress works for, how it works, and why or why not. Aims: To deliver and evaluate an NHS care pathway for all people with type 1 diabetes that recognises the normal emotional distress associated with managing this complex condition, providing interventions to prevent distress before it escalates and to manage it when it does.