{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:24Z","timestamp":1792384884592,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["ACF\u20102024\u201003\u2010003"],"award-info":[{"award-number":["ACF\u20102024\u201003\u2010003"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the association between prior diabetes\u2010related hospital admissions and diabetes distress and determine whether structured diabetes education modifies this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We analysed 14\u2009460 adults from the Association of British Clinical Diabetologists (ABCD) National FreeStyle Libre Audit. High diabetes distress was defined using the two\u2010item Diabetes Distress Scale (DDS\u20102; mean score \u2265\u20093). Diabetes\u2010related hospital admissions during the preceding 12\u2009months were categorised as none, single or recurrent (\u2265\u20092). Multivariable logistic regression examined associations between admissions and distress after adjustment for demographic and clinical factors. Interaction between admissions and structured education was assessed using likelihood ratio testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants had a mean age of 42.3\u2009\u00b1\u200918.1\u2009years, 47.7% were female and most had type 1 diabetes. High diabetes distress was present in 51.5% of participants. In the complete\u2010case cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098017), recurrent diabetes\u2010related admissions were independently associated with high diabetes distress (adjusted odds ratio [aOR] 1.94, 95% CI 1.48\u20132.57), whereas single admissions were not. Recurrent non\u2010diabetes admissions were not independently associated with distress. Significant interaction was observed between admissions and structured education (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among individuals with recurrent admissions, distress prevalence was lower among those reporting structured education (64.1% vs. 80.4%). Hypoglycaemia\u2010related and other diabetes\u2010related admissions were independently associated with distress.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recurrent diabetes\u2010related hospital admissions are strongly associated with diabetes distress, with the independent association driven by recurrent rather than isolated events. Lower distress among individuals reporting structured education supports further evaluation of integrated psychosocial and educational approaches following acute diabetes\u2010related hospital admission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71198","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:21:43Z","timestamp":1786519303000},"page":"10028-10036","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent Diabetes\u2010Related Hospital Admissions and Diabetes Distress: Real\u2010World Evidence From the Association of British Clinical Diabetologists (\n                    <scp>ABCD<\/scp>\n                    ) National Freestyle Libre Audit"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7943-0454","authenticated-orcid":false,"given":"Jude","family":"Wellens\u2010Mensah","sequence":"first","affiliation":[{"name":"Allam Diabetes Centre University of Hull  Hull UK"},{"name":"Hull University Teaching Hospitals National Health Service (NHS) Trust  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshal","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"James Cook University  Townsville Queensland Australia"},{"name":"Gold Coast University Hospital  Southport Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2796-5027","authenticated-orcid":false,"given":"Emmanuel","family":"Ssemmondo","sequence":"additional","affiliation":[{"name":"Allam Diabetes Centre University of Hull  Hull UK"},{"name":"Hull University Teaching Hospitals National Health Service (NHS) Trust  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Walton","sequence":"additional","affiliation":[{"name":"Allam Diabetes Centre University of Hull  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4424-355X","authenticated-orcid":false,"given":"Robert E. 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