{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:46:35Z","timestamp":1782297995711,"version":"3.54.5"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Diabetes Sci Technol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Recent advances in diabetes care and technology, such as real-time continuous glucose monitoring, can help people live more freely, with more flexibility and fewer constraints, thereby enhancing quality of life (QOL). To date, there has been no validated means for measuring this key psychological dimension. We developed the Diabetes Constraints Scale (DCS) to assess perceived constraints pertaining to diabetes self-management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Six items were developed from qualitative interviews (20 adults with type 2 diabetes [T2D], 8 adults with type 1 diabetes [T1D]). Items were included in one study with T2D adults (N = 458) and one with T1D adults (N = 574). Scale reliability was analyzed for each study using exploratory factor analyses. Associations between DCS and key psychosocial and glycemic variables were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In both studies, factor analyses revealed a single factor, with adequate internal reliability (Cronbach\u2019s alpha &gt;.80). Both studies demonstrated significant associations in the expected direction between DCS and overall well-being, diabetes-specific QOL, and diabetes distress (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). In both studies, DCS was positively linked with the number of missed insulin boluses and the frequency of severe hypoglycemic episodes (T1D both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001; T2D both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .005) and\u2014in the T1D group only\u2014with HbA\n                      <jats:sub>1c<\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The DCS is a reliable and valid method to determine the degree to which adults with diabetes feel constrained or limited by the disease. It may serve as a useful tool for assessing how new interventions can help individuals feel freer in the face of the demands of diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19322968241308269","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T02:22:13Z","timestamp":1735266133000},"page":"905-912","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["How Might We Tell if Advances in Diabetes Care and Technology Are Helping People to Feel Less Constrained? Introducing the Diabetes Constraints Scale"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9064-6144","authenticated-orcid":false,"given":"William H.","family":"Polonsky","sequence":"first","affiliation":[{"name":"Behavioral Diabetes Institute, San Diego, CA, USA"},{"name":"University of California San Diego, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1069-9324","authenticated-orcid":false,"given":"Emily C.","family":"Soriano","sequence":"additional","affiliation":[{"name":"Scripps Whittier Diabetes Institute, Scripps Health, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Strycker","sequence":"additional","affiliation":[{"name":"Oregon Research Institute, Springfield, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9481-9727","authenticated-orcid":false,"given":"Lawrence","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-7560(199905\/06)15:3<205::AID-DMRR29>3.0.CO;2-O"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14196"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S87310"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-020-02753-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-018-0883-1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.109998"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.03.020"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2021.108103"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15282"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968231198533"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1037\/pas0000626"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12040"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2020.107606"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd22-0131"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2019.10.003"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102119"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.55.1.68"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.01.012"}],"container-title":["Journal of Diabetes Science and Technology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19322968241308269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19322968241308269","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19322968241308269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T09:52:20Z","timestamp":1782294740000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19322968241308269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,26]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/19322968241308269"],"URL":"https:\/\/doi.org\/10.1177\/19322968241308269","relation":{},"ISSN":["1932-2968","1932-2968"],"issn-type":[{"value":"1932-2968","type":"print"},{"value":"1932-2968","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,26]]}}}