{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T14:23:45Z","timestamp":1750947825932},"reference-count":61,"publisher":"Walter de Gruyter GmbH","issue":"9","license":[{"start":{"date-parts":[[2019,9,1]],"date-time":"2019-09-01T00:00:00Z","timestamp":1567296000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_jaoa.2019.099_s_001\"><jats:title>Context<\/jats:title><jats:p>Diabetes distress is an affective condition that addresses an individual's frustrations, worries, and concerns about living with diabetes. It is associated with fewer self-care behaviors, suboptimal glycemic control, and lower quality of life (QOL). For these reasons, diabetes care guidelines recommend routine assessment of diabetes distress.<\/jats:p><\/jats:sec><jats:sec id=\"j_jaoa.2019.099_s_002\"><jats:title>Objective<\/jats:title><jats:p>To assess diabetes distress in a university population.<\/jats:p><\/jats:sec><jats:sec id=\"j_jaoa.2019.099_s_003\"><jats:title>Methods<\/jats:title><jats:p>This study was conducted using a descriptive, cross-sectional design. Researchers assessed diabetes distress and other psychosocial factors via an electronic anonymous survey among students, faculty, and staff at a large university in the Midwest.<\/jats:p><\/jats:sec><jats:sec id=\"j_jaoa.2019.099_s_004\"><jats:title>Results<\/jats:title><jats:p>A total of 173 participants completed the survey (mean [SD] age, 35.1 [16.7] years), with 108 [62.4%] female and 142 [82.1%] white participants). Eighty-five participants had type 1 diabetes mellitus (T1DM), and 88 had type 2 diabetes mellitus (T2DM). Of the 85 T1DM participants, 23 (27.4%) reported high diabetes distress, and 27 (30.7%) T2DM participants reported high diabetes distress. Sixteen T1DM (18.8%) and 15 T2DM (17.0%) participants screened positive for severe depression. Severe depression was associated with high distress for both T1DM and T2DM participants (T1DM: \u03c7<jats:sup>2<\/jats:sup>=28.845,<jats:italic>P<\/jats:italic>&lt;.001; T2DM: \u03c7<jats:sup>2<\/jats:sup>=20.679,<jats:italic>P<\/jats:italic>&lt;.001). Participants with T1DM reported more frequent self-care behaviors (mean [SD], 62.3 [17.1] vs 52.2 [19.2];<jats:italic>P<\/jats:italic>&lt;.001), but lower diabetes QOL (63.3 [14.1] vs 68.5 [15.5];<jats:italic>P<\/jats:italic>=.021) compared with T2DM participants. No differences were observed in depressive symptoms, diabetes self-efficacy, and coping styles. Linear regression models showed that high diabetes distress scores (standardized \u03b2=.323,<jats:italic>P<\/jats:italic>=.025; standardized \u03b2=.604,<jats:italic>P<\/jats:italic>&lt;.001) were independently associated with higher hemoglobin A<jats:sub>1C<\/jats:sub>levels and lower diabetes QOL after controlling for depressive symptoms, age, and gender in T1DM participants. Similarly, high diabetes distress scores (standardized \u03b2=.434,<jats:italic>P<\/jats:italic>&lt;.001) were associated with lower diabetes QOL in T2DM participants after controlling for the same variables.<\/jats:p><\/jats:sec><jats:sec id=\"j_jaoa.2019.099_s_005\"><jats:title>Conclusion<\/jats:title><jats:p>High diabetes distress levels were associated with lower diabetes QOL for both T1DM and T2DM participants. These findings suggest that attending or working at a university may be associated with high diabetes distress scores and lower diabetes QOL. Additional research with a larger, more diverse sample from multiple universities is needed to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.7556\/jaoa.2019.099","type":"journal-article","created":{"date-parts":[[2019,8,26]],"date-time":"2019-08-26T14:31:05Z","timestamp":1566829865000},"page":"556-568","source":"Crossref","is-referenced-by-count":10,"title":["High Prevalence of Diabetes Distress in a University Population"],"prefix":"10.1515","volume":"119","author":[{"given":"Elizabeth A.","family":"Beverly","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rochelle G.","family":"Rennie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily H.","family":"Guseman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Rodgers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber M.","family":"Healy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2019,9,1]]},"reference":[{"key":"2022022617435784926_j_jaoa.2019.099_ref_001","volume-title":"National Diabetes Statistics Report, 2017","year":"2017"},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_002","first-page":"S46","volume":"42","author":"American Diabetes Association. Lifestyle management:","year":"2019","journal-title":"Standards of Medical Care in Diabetes-2019. Diabetes Care."},{"issue":"(suppl 1)","key":"2022022617435784926_j_jaoa.2019.099_ref_003","first-page":"S71","volume":"42","author":"American Diabetes Association. Diabetes technology:","year":"2019","journal-title":"Standards of Medical Care in Diabetes-2019. Diabetes Care"},{"issue":"4","key":"2022022617435784926_j_jaoa.2019.099_ref_004","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s13300-017-0280-5","article-title":"Achievement of glycated hemoglobin goals in the US remains unchanged through 2014","volume":"8","author":"Carls","year":"2017","journal-title":"Diabetes Ther."},{"issue":"5","key":"2022022617435784926_j_jaoa.2019.099_ref_005","doi-asserted-by":"crossref","first-page":"760","DOI":"10.2337\/diacare.20.5.760","article-title":"The problem areas in diabetes scale an evaluation of its clinical utility.","volume":"20","author":"Welch","year":"1997","journal-title":"Diabetes Care."},{"issue":"2","key":"2022022617435784926_j_jaoa.2019.099_ref_006","doi-asserted-by":"crossref","first-page":"121","DOI":"10.2337\/diaspect.18.2.121","article-title":"Stress and diabetes: a review of the links","volume":"18","author":"Lloyd","year":"2005","journal-title":"Diabetes Spectrum."},{"issue":"6","key":"2022022617435784926_j_jaoa.2019.099_ref_007","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/01.NAJ.0000277825.97548.65","article-title":"Psychosocial issues and self-care [quiz 38].","volume":"107","author":"Weinger","year":"2007","journal-title":"Am J Nurs."},{"issue":"2","key":"2022022617435784926_j_jaoa.2019.099_ref_008","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0738-3991(00)00098-7","article-title":"Psychosocial and quality of life correlates of glycemic control during intensive treatment of type 1 diabetes","volume":"42","author":"Weinger","year":"2001","journal-title":"Patient Educ Couns."},{"issue":"5","key":"2022022617435784926_j_jaoa.2019.099_ref_009","first-page":"354","article-title":"Predictors of self-care behavior in adults with type 2 diabetes: an RRNeST study","volume":"33","author":"Albright","year":"2001","journal-title":"Fam Med."},{"issue":"10","key":"2022022617435784926_j_jaoa.2019.099_ref_010","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1007\/s00125-008-1113-x","article-title":"Differentiating symptoms of depression from diabetes-specific distress: relationships with self-care in type 2 diabetes","volume":"51","author":"Gonzalez","year":"2008","journal-title":"Diabetologia."},{"issue":"9","key":"2022022617435784926_j_jaoa.2019.099_ref_011","doi-asserted-by":"crossref","first-page":"2222","DOI":"10.2337\/dc07-0158","article-title":"Depression, self-care, and medication adherence in type 2 diabetes: relationships across the full range of symptom severity","volume":"30","author":"Gonzalez","year":"2007","journal-title":"Diabetes Care."},{"issue":"9","key":"2022022617435784926_j_jaoa.2019.099_ref_012","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1111\/j.1464-5491.2008.02535.x","article-title":"Symptoms of depression prospectively predict poorer self-care in patients with type 2 diabetes","volume":"25","author":"Gonzalez","year":"2008","journal-title":"Diabet Med."},{"issue":"6","key":"2022022617435784926_j_jaoa.2019.099_ref_013","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/j.1464-5491.2009.02730.x","article-title":"Predicting diabetes distress in patients with type 2 diabetes: a longitudinal study","volume":"26","author":"Fisher","year":"2009","journal-title":"Diabet Med."},{"issue":"3","key":"2022022617435784926_j_jaoa.2019.099_ref_014","doi-asserted-by":"crossref","first-page":"542","DOI":"10.2337\/dc06-1614","article-title":"Clinical depression versus distress among patients with type 2 diabetes: not just a question of semantics","volume":"30","author":"Fisher","year":"2007","journal-title":"Diabetes Care."},{"issue":"7","key":"2022022617435784926_j_jaoa.2019.099_ref_015","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1111\/dme.12428","article-title":"The confusing tale of depression and distress in patients with diabetes: a call for greater clarity and precision","volume":"31","author":"Fisher","year":"2014","journal-title":"Diabet Med."},{"issue":"5","key":"2022022617435784926_j_jaoa.2019.099_ref_016","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.2337\/dc09-2175","article-title":"The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes","volume":"33","author":"Fisher","year":"2010","journal-title":"Diabetes Care."},{"issue":"7","key":"2022022617435784926_j_jaoa.2019.099_ref_017","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1111\/dme.12245","article-title":"Diabetes Attitudes, Wishes and Needs second study (DAWN2\u2122): cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes","volume":"30","author":"Nicolucci","year":"2013","journal-title":"Diabet Med."},{"issue":"2","key":"2022022617435784926_j_jaoa.2019.099_ref_018","doi-asserted-by":"publisher","first-page":"259","DOI":"10.2337\/dc11-1572","article-title":"When is diabetes distress clinically meaningful?: establishing cut points for the Diabetes Distress Scale","volume":"35","author":"Fisher","year":"2012","journal-title":"Diabetes Care."},{"issue":"3","key":"2022022617435784926_j_jaoa.2019.099_ref_019","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1080\/20573316.2016.1202497","article-title":"High rates of elevated diabetes distress in research populations: a systematic review and meta-analysis","volume":"12","author":"Dennick","year":"2015","journal-title":"Int Diabetes Nurs."},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_020","doi-asserted-by":"publisher","first-page":"23","DOI":"10.2337\/dc09-1238","article-title":"Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses","volume":"33","author":"Fisher","year":"2010","journal-title":"Diabetes Care."},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_021","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.psym.2012.08.004","article-title":"Putting PAID to diabetes-related distress: the potential utility of the problem areas in diabetes (PAID) scale in patients with diabetes","volume":"54","author":"Reddy","year":"2013","journal-title":"Psychosomatics."},{"issue":"6","key":"2022022617435784926_j_jaoa.2019.099_ref_022","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1177\/0145721707309808","article-title":"Healthy coping, negative emotions, and diabetes management: a systematic review and appraisal.","volume":"33","author":"Fisher","year":"2007","journal-title":"Diabetes Educ."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_023","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/s12955-015-0384-4","article-title":"Negative effects of diabetes-related distress on health-related quality of life: an evaluation among the adult patients with type 2 diabetes mellitus in three primary healthcare clinics in Malaysia","volume":"13","author":"Chew","year":"2015","journal-title":"Health Qual Life Outcomes."},{"issue":"3","key":"2022022617435784926_j_jaoa.2019.099_ref_024","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1007\/s10865-013-9505-x","article-title":"The differential associations of depression and diabetes distress with quality of life domains in type 2 diabetes","volume":"37","author":"Carper","year":"2014","journal-title":"J Behav Med."},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_025","first-page":"S1","volume":"42","author":"American Diabetes Association.","year":"2019","journal-title":"Standards of Medical Care in Diabetes-2019. Diabetes Care."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_026","article-title":"Enrollment and Employees in Postsecondary Institutions, Fall 2016; and Financial Statistics and Academic Libraries, Fiscal Year 2016.","author":"Ginder","year":"2017"},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_027","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1080\/13600800500283734","article-title":"Academic staff workloads and job satisfaction: expectations and values in academe","volume":"28","author":"Houston","year":"2006","journal-title":"J Higher Educ Policy Manage."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_028"},{"key":"2022022617435784926_j_jaoa.2019.099_ref_029"},{"issue":"3","key":"2022022617435784926_j_jaoa.2019.099_ref_030","doi-asserted-by":"crossref","first-page":"626","DOI":"10.2337\/diacare.28.3.626","article-title":"Assessing psychosocial distress in diabetes: development of the diabetes distress scale","volume":"28","author":"Polonsky","year":"2005","journal-title":"Diabetes Care."},{"issue":"4","key":"2022022617435784926_j_jaoa.2019.099_ref_031","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.jdiacomp.2015.01.012","article-title":"Understanding the sources of diabetes distress in adults with type 1 diabetes","volume":"29","author":"Fisher","year":"2015","journal-title":"J Diabetes Complications."},{"issue":"9","key":"2022022617435784926_j_jaoa.2019.099_ref_032","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med."},{"issue":"6","key":"2022022617435784926_j_jaoa.2019.099_ref_033","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.2337\/diacare.28.6.1346","article-title":"Measuring diabetes self-care: a psychometric analysis of the Self-Care Inventory-Revised with adults","volume":"28","author":"Weinger","year":"2005","journal-title":"Diabetes Care."},{"issue":"2","key":"2022022617435784926_j_jaoa.2019.099_ref_034","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2307\/2676370","article-title":"A biopsychosocial model of glycemic control in diabetes: stress, coping and regimen adherence","volume":"40","author":"Peyrot","year":"1999","journal-title":"J Health Soc Behav."},{"issue":"3","key":"2022022617435784926_j_jaoa.2019.099_ref_035","doi-asserted-by":"crossref","first-page":"713","DOI":"10.2337\/diacare.26.3.713","article-title":"The confidence in diabetes self-care scale: psychometric properties of a new measure of diabetes-specific self-efficacy in Dutch and US patients with type 1 diabetes","volume":"26","author":"van der Ven","year":"2003","journal-title":"Diabetes Care."},{"issue":"suppl","key":"2022022617435784926_j_jaoa.2019.099_ref_036","first-page":"A318","article-title":"Psychological influences on glycemic control and self-management in type 1 diabetes [abstract].","volume":"48","author":"Weinger","year":"2000","journal-title":"Diabetes."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_037","article-title":"The Diabetes Quality of Life Measure.","volume-title":"Handbook of Psychology and Diabetes.","author":"Jacobson","year":"1994"},{"issue":"4","key":"2022022617435784926_j_jaoa.2019.099_ref_038","doi-asserted-by":"crossref","first-page":"267","DOI":"10.2337\/diacare.17.4.267","article-title":"The evaluation of two measures of quality of life in patients with type I and type II diabetes","volume":"17","author":"Jacobson","year":"1994","journal-title":"Diabetes Care."},{"issue":"9","key":"2022022617435784926_j_jaoa.2019.099_ref_039","first-page":"725","volume":"11","year":"1988"},{"key":"2022022617435784926_j_jaoa.2019.099_ref_040","volume-title":"How to Score the SF-36 Health Survey.","year":"1993"},{"issue":"2","key":"2022022617435784926_j_jaoa.2019.099_ref_041","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s12160-013-9585-4","article-title":"Diabetes burden and diabetes distress: the buffering effect of social support","volume":"48","author":"Baek","year":"2014","journal-title":"Ann Behav Med."},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_042","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1037\/hea0000250","article-title":"Associations between coping strategies and mental health in individuals with type 2 diabetes: prospective analyses","volume":"35","author":"Burns","year":"2016","journal-title":"Health Psychol."},{"issue":"2","key":"2022022617435784926_j_jaoa.2019.099_ref_043","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.jpsychores.2013.05.009","article-title":"Diabetes distress and neighborhood characteristics in people with type 2 diabetes","volume":"75","author":"Gariepy","year":"2013","journal-title":"J Psychosom Res."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_044","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.diabres.2015.12.011","article-title":"Willingness to initiate insulin among adults with type 2 diabetes in Australian primary care: results from the Stepping Up Study","volume":"114","author":"Holmes-Truscott","year":"2016","journal-title":"Diabetes Res Clin Pract."},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_045","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.psym.2012.08.002","article-title":"Exploring the association of psychological status with self-rated diabetes control: results from the Montreal evaluation of diabetes treatment study","volume":"54","author":"Smith","year":"2013","journal-title":"Psychosomatics."},{"issue":"6","key":"2022022617435784926_j_jaoa.2019.099_ref_046","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.jcjd.2015.09.053","article-title":"Diabetes distress is associated with poor glycemic control among patients with type 2 diabetes presenting to a tertiary care setting in Vancouver","volume":"39","author":"Wong","year":"2015","journal-title":"Can J Diabetes."},{"issue":"4","key":"2022022617435784926_j_jaoa.2019.099_ref_047","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s00592-015-0832-y","article-title":"Psychosocial factors not metabolic control impact the quality of life among patients with type 2 diabetes in China","volume":"53","author":"Zhu","year":"2016","journal-title":"Acta Diabetol."},{"issue":"11","key":"2022022617435784926_j_jaoa.2019.099_ref_048","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1111\/dme.13448","article-title":"The prevalence of diabetes-specific emotional distress in people with type 2 diabetes: a systematic review and meta-analysis","volume":"34","author":"Perrin","year":"2017","journal-title":"Diabet Med."},{"issue":"9","key":"2022022617435784926_j_jaoa.2019.099_ref_049","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1111\/dme.13381","article-title":"Diabetes distress is linked with worsening diabetes management over time in adults with type 1 diabetes","volume":"34","author":"Hessler","year":"2017","journal-title":"Diabet Med."},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_050","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/NMD.0b013e31827ab077","article-title":"Mental health in American colleges and universities: variation across student subgroups and across campuses","volume":"201","author":"Eisenberg","year":"2013","journal-title":"J Nerv Ment Dis."},{"issue":"1","key":"2022022617435784926_j_jaoa.2019.099_ref_051","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.pcd.2015.06.007","article-title":"Associations between patient characteristics, social relations, diabetes management, quality of life, glycaemic control and emotional burden in type 1 diabetes","volume":"10","author":"Joensen","year":"2016","journal-title":"Prim Care Diabetes."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_052"},{"issue":"7","key":"2022022617435784926_j_jaoa.2019.099_ref_053","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.2337\/diaclin.34.2.70","article-title":"Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics","volume":"38","author":"Powers","year":"2015","journal-title":"Diabetes Care."},{"issue":"6","key":"2022022617435784926_j_jaoa.2019.099_ref_054","doi-asserted-by":"crossref","first-page":"754","DOI":"10.2337\/diacare.18.6.754","article-title":"Assessment of diabetes-related distress","volume":"18","author":"Polonsky","year":"1995","journal-title":"Diabetes Care."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_055","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1179\/2057332415Y.0000000004","article-title":"Effective interventions for reducing diabetes distress: systematic review and meta-analysis","volume":"12","author":"Sturt","year":"2015","journal-title":"Int Diabetes Nurs."},{"issue":"9","key":"2022022617435784926_j_jaoa.2019.099_ref_056","doi-asserted-by":"crossref","first-page":"2551","DOI":"10.2337\/dc12-2493","article-title":"REDEEM: a pragmatic trial to reduce diabetes distress","volume":"36","author":"Fisher","year":"2013","journal-title":"Diabetes Care."},{"issue":"4","key":"2022022617435784926_j_jaoa.2019.099_ref_057","doi-asserted-by":"crossref","first-page":"551","DOI":"10.2337\/dc14-1416","article-title":"The effect of a Diabetes-Specific Cognitive Behavioral Treatment Program (DIAMOS) for patients with diabetes and subclinical depression: results of a randomized controlled trial","volume":"38","author":"Hermanns","year":"2015","journal-title":"Diabetes Care."},{"issue":"10","key":"2022022617435784926_j_jaoa.2019.099_ref_058","doi-asserted-by":"publisher","first-page":"S13","DOI":"10.7326\/M13-3012","article-title":"Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.","author":"Heisler","year":"2014","journal-title":"Ann Intern Med."},{"issue":"9","key":"2022022617435784926_j_jaoa.2019.099_ref_059","doi-asserted-by":"publisher","first-page":"1862","DOI":"10.2337\/dc18-0391","article-title":"T1-REDEEM: a randomized controlled trial to reduce diabetes distress among adults with type 1 diabetes","volume":"41","author":"Fisher","year":"2018","journal-title":"Diabetes Care."},{"key":"2022022617435784926_j_jaoa.2019.099_ref_060"},{"issue":"2","key":"2022022617435784926_j_jaoa.2019.099_ref_061","doi-asserted-by":"publisher","first-page":"181","DOI":"10.2337\/dc16-1536","article-title":"Diabetes device use in adults with type 1 diabetes: barriers to uptake and potential intervention targets","volume":"40","author":"Tanenbaum","year":"2017","journal-title":"Diabetes Care."}],"container-title":["Journal of Osteopathic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.7556\/jaoa.2019.099\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.7556\/jaoa.2019.099\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T11:59:46Z","timestamp":1664193586000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.7556\/jaoa.2019.099\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,1]]},"references-count":61,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,1]]},"published-print":{"date-parts":[[2019,9,1]]}},"alternative-id":["10.7556\/jaoa.2019.099"],"URL":"https:\/\/doi.org\/10.7556\/jaoa.2019.099","relation":{},"ISSN":["2702-3648"],"issn-type":[{"value":"2702-3648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,1]]}}}