{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:25:17Z","timestamp":1773005117003,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32DK007028"],"award-info":[{"award-number":["T32DK007028"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We determined whether a global measure of environmental mastery (EM) was associated with diabetes distress (DD) among young adults with type 1 diabetes (T1D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In 2017, an online survey was completed by 423 of 743 (57%) young adults (19\u201331\u2009years) with T1D receiving care at a speciality clinic in New York City. Linear regression was used to examine the association between EM scores (7\u2010item scale from Ryff's Scales of Psychological Well\u2010Being) and DD scores (17\u2010item Diabetes Distress Scale), adjusting for HbA1\n                      <jats:sub>c<\/jats:sub>\n                      levels and sociodemographic and clinical covariates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 416 participants with complete data on EM and DD, the mean (SD) age was 24.5 (3.2) years. Fifty\u2010nine per cent were female and 70% were Non\u2010Hispanic White. The mean HbA1\n                      <jats:sub>c<\/jats:sub>\n                      level was 64 (18) mmol\/mol\/8.0 (1.7) %, the mean EM score was 33.5\u2009\u00b1\u20098.7 and the mean DD score was 2.3\u2009\u00b1\u20091.0. For each 1 SD increase in EM score, there was a 0.51 SD decrease (95% confidence interval [CI]: 0.43, 0.59) in the covariate\u2010adjusted DD score. This inverse association between EM and DD was of similar magnitude among those with HbA1\n                      <jats:sub>c<\/jats:sub>\n                      levels in the target range (&lt;53\u2009mmol\/mol [&lt;7.0%]) and those with HbA1\n                      <jats:sub>c<\/jats:sub>\n                      levels not in the target range.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Greater EM was associated with lower DD. Reducing DD in young adults with T1D may require a better understanding of the developmental processes that lead to a sense of global mastery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70061","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T22:40:05Z","timestamp":1746830405000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association of environmental mastery and diabetes distress among young adults with type 1 diabetes"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8055-8183","authenticated-orcid":false,"given":"Kathryn E.","family":"Nagel","sequence":"first","affiliation":[{"name":"Divisions of Endocrinology and Pediatric Endocrinology Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts 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