{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:36:18Z","timestamp":1753889778513,"version":"3.41.2"},"reference-count":0,"publisher":"American Diabetes Association","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n OBJECTIVE<\/jats:title>\n To test the association of autonomic nervous system (ANS) dysregulation symptoms and diabetes distress (DD) in adults with type 1 diabetes (T1D; study 1) and type 2 diabetes (T2D; study 2).<\/jats:p>\n <\/jats:sec>\n \n RESEARCH DESIGN AND METHODS<\/jats:title>\n A total of 556 adults with T1D and 299 with T2D completed the Body Perception Questionnaire (BPQ) to assess ANS reactivity symptoms, diabetes distress (via Diabetes Distress Scale T1 [DDS-T1], and DDS-17), anxiety (via General Anxiety Disorder 7 [GAD-7]) scale, depression (via Patient Health Questionnaire-8 [PHQ-8]), and demographic variables via internet surveys.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n In study 1, participants\u2019 mean age was 45.1 (SD 15.7) years and most were female (73.2%) and White (95.3%). The mean self-reported A1c was 6.7% (SD = 1.0%); mean duration of T1D diagnosis 20.6 (SD 14.7) years; and 72.5% of participants reported using an insulin pump. The mean DDS-T1 score was 2.3 (SD 0.8; moderate severity). The BPQ mean T score was 48.9 (SD 8.4) for supradiaphragmatic and 50.6 (SD 8.9) for subdiaphragmatic reactivity subscales. In study 2, participants\u2019 mean age was 60.2 (SD 13.6) years, 58.7% were female, and 82.9% were White. The mean self-reported A1c was 7.0% (SD 1.2%), and 51.8% of participants were treated with oral hypoglycemic agents and 39.9% used oral and injectable medications. The mean duration of T2D diagnosis was 15.0 (SD 10.0) years. The mean DDS-17 score was 2.3 (SD 1.0; moderate severity) and BPQ mean T score was 49.9 (SD 9.4) for supradiaphragmatic and 52.0 (SD 8.8) for subdiaphragmatic reactivity subscales. Controlling for covariates, severity of DDS-T1\/DDS-17 significantly predicted elevations in ANS symptom T scores on all subscales (P \u2264 0.05 for all), with \u201chigh\u201d DDS having the highest BPQ scores.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n These findings demonstrate a relationship between ANS reactivity and DDS in T1D and T2D samples.<\/jats:p>\n <\/jats:sec>","DOI":"10.2337\/dc24-2614","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T17:10:57Z","timestamp":1743441057000},"update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Symptoms of Autonomic Nervous System Dysregulation and Diabetes Distress in Adults With Type 1 and Type 2 Diabetes"],"prefix":"10.2337","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4021-8824","authenticated-orcid":false,"given":"Mary","family":"de Groot","sequence":"first","affiliation":[{"name":"1Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara A.","family":"Myers","sequence":"additional","affiliation":[{"name":"1Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy E.","family":"Stump","sequence":"additional","affiliation":[{"name":"1Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deb","family":"Dana","sequence":"additional","affiliation":[{"name":"2Independent Scholar, Chicago, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Lewis","sequence":"additional","affiliation":[{"name":"3Indiana University Kinsey Institute, Bloomington, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Kolacz","sequence":"additional","affiliation":[{"name":"4The Ohio State College of Medicine, Columbus, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Baker","sequence":"additional","affiliation":[{"name":"1Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly A.","family":"Fox","sequence":"additional","affiliation":[{"name":"1Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen W.","family":"Porges","sequence":"additional","affiliation":[{"name":"3Indiana University Kinsey Institute, Bloomington, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2025,3,31]]},"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc24-2614\/802730\/dc242614.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/doi\/10.2337\/dc24-2614\/802730\/dc242614.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T17:10:57Z","timestamp":1743441057000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/doi\/10.2337\/dc24-2614\/158053\/Symptoms-of-Autonomic-Nervous-System-Dysregulation"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,31]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2337\/dc24-2614","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"type":"print","value":"0149-5992"},{"type":"electronic","value":"1935-5548"}],"subject":[],"published":{"date-parts":[[2025,3,31]]},"article-number":"dc242614"}}