Assessing Diabetes Distress in Emerging Adults With Type 1 Diabetes: Development and Validation of the Problem Areas in Diabetes-Emerging Adult Version

Document Type


Publication Date



Endocrinology and Diabetes

Journal Title

Canadian journal of diabetes


OBJECTIVES: Emerging adults (18 to 30 years of age) with type 1 diabetes experience suboptimal glycemic and psychological outcomes compared with other groups. The emotional burden of the unending self-care needs of diabetes management appears to be related to these poor health outcomes. However, there is no validated measure of this emotional burden in the developmental context of emerging adulthood. The primary aim of this study was to examine the psychometric properties of a new measure of diabetes distress in emerging adults with type 1 diabetes in the United States. METHODS: In this cross-sectional study, emerging adults with type 1 diabetes completed an online survey, including measures of diabetes distress, depressive symptomology and the newly developed measure, the Problem Areas in Diabetes-Emerging Adult version (PAID-EA). Participants also answered demographic and clinical outcomes questions. Internal consistency, reliability, construct validity and the underlying factor structure of the PAID-EA were assessed. RESULTS: Participants (N=287, 78% women) had a median age of 24 years, 43% were full-time students, 78% wore an insulin pump and 90% used a continuous glucose monitor. Mean self-reported glycated hemoglobin was 7.1%±1.2%. The PAID-EA demonstrated good internal consistency and reliability (Cronbach α=0.89), was composed of one component accounting for 29% of the observed variance and demonstrated construct validity as it was significantly correlated with known measures of similar constructs, and with glycated hemoglobin levels (ρ=0.20, p=0.001). CONCLUSIONS: The PAID-EA holds promise as a reliable and valid measure of diabetes distress in emerging adults.